The biggest misconceptions about gastroenterology

Gastroenterology is a very common medical specialty, but it is not without its misconceptions. 

Benjamin Levy III, MD, a gastroenterologist and clinical associate of medicine at the University of Chicago Medicine, connected with Becker's to discuss the biggest misconceptions about gastroenterology. 

Note: This response has been lightly edited for length and clarity.

Dr. Benjamin Levy III: While most people think of gastroenterology as a diagnosing specialty (finding polyps and colon cancers via colonoscopies), another main goal is to prevent colon cancer. We prevent colon cancer by removing polyps with snares and biopsy forceps before polyps can turn into a cancer. I love gastroenterology because of our ability to prevent cancer. We also prevent esophageal cancer by treating dysplasia in patients with Barrett's esophagus from chronic GERD/reflux.

Many people think that gastroenterologists just focus on the stomach and colon. However, we're not just poop doctors. Gastroenterologists treat every part of digestion, including the liver, gallbladder, pancreas, stomach, small bowel and colon. We treat patients with hepatitis and manage cirrhosis. We have the ability to remove stones stuck in the common bile duct with endoscopic retrograde cholangiopancreatography procedures. We manage patients with pancreatitis. 

The term "endoscopy" can refer to both esophagogastroduodenoscopy (EGD) and colonoscopy procedures (not just EGD/upper scope). Endoscopy is a general term for procedures where gastroenterologists use a flexible tube with a light and camera to examine the gastrointestinal tract.

Many patients fear that colonoscopies are going to be painful; however, most patients are super comfortable, sleepy and unaware of the procedure. We very carefully sedate patients for their EGD and colonoscopy procedures. Many patients are sedated for colonoscopies with the help of anesthesiologists using a fantastic medication called propofol, which wears off super quickly after procedures. We very carefully make sure that each patient is comfortable throughout their colonoscopy procedure.

Many patients think that colonoscopy is the only way to get screened for colon cancer.  Colonoscopies are great procedures because gastroenterologists can remove polyps to prevent cancer. However, some patients (especially patients who are very sick with other serious illnesses such as heart failure or a recent stroke) choose to be screened for colon cancer with FIT (fecal immunochemical testing) or Cologuard testing, which are stool-based tests. Patients with a positive FIT or Cologuard test result will need a follow-up diagnostic colonoscopy to try to figure out why the stool-based test turned positive.  

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