Gastroenterology
Encyclopedia
Gastroenterology is the branch of medicine
whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek
words gaster (gen.: gastros) (stomach
), enteron (intestine
), and logos
(reason
). In the U.S., Gastroenterology is an Internal Medicine Subspecialty certified by the ABIM (www.abim.org).
Diseases affecting the gastrointestinal tract
, which includes the organs
from mouth
to anus
, along the alimentary canal, are the focus of this specialty. Physicians practicing in this field of medicine are called gastroenterologists. They have usually completed the eight years of pre-medical and medical education, the yearlong internship (if this is not a part of the residency), three years of an internal medicine residency, and two to three years in the gastroenterology fellowship. Some gastroenterology trainees will complete a "fourth-year" (although this is often their 7th year of graduate medical education) in Transplant Hepatology, Advanced Endoscopy, IBD, motility or other topics.
Gastroenterology is not the same as colorectal or hepatobiliary surgery, which are specialty branches of general surgery.
Hepatology
, or hepatobiliary medicine, encompasses the study of the liver
, pancreas
, and biliary tree
, and is traditionally considered a sub-specialty.
papyri
, Nunn identified significant knowledge of gastrointestinal diseases among practising physicians during the periods of the pharaoh
s. Irynakhty, of the tenth dynasty, c. 2125 B.C., was a court physician
specialising in gastroenterology and proctology
.
Among ancient Greeks
, Hippocrates
attributed digestion
to concoction. Galen
's concept of the stomach
having four faculties was widely accepted up to modernity in the seventeenth century.
Eighteenth century:
Nineteenth century:
Twentieth century:
Twenty-first century:
2007)/WHO classification:
2. MeSH
subject Heading:
3. National Library of Medicine Catalogue(NLM classification 2006):
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek
Ancient Greek
Ancient Greek is the stage of the Greek language in the periods spanning the times c. 9th–6th centuries BC, , c. 5th–4th centuries BC , and the c. 3rd century BC – 6th century AD of ancient Greece and the ancient world; being predated in the 2nd millennium BC by Mycenaean Greek...
words gaster (gen.: gastros) (stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
), enteron (intestine
Intestine
In human anatomy, the intestine is the segment of the alimentary canal extending from the pyloric sphincter of the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine...
), and logos
Logos
' is an important term in philosophy, psychology, rhetoric and religion. Originally a word meaning "a ground", "a plea", "an opinion", "an expectation", "word," "speech," "account," "reason," it became a technical term in philosophy, beginning with Heraclitus ' is an important term in...
(reason
Reason
Reason is a term that refers to the capacity human beings have to make sense of things, to establish and verify facts, and to change or justify practices, institutions, and beliefs. It is closely associated with such characteristically human activities as philosophy, science, language, ...
). In the U.S., Gastroenterology is an Internal Medicine Subspecialty certified by the ABIM (www.abim.org).
Diseases affecting the gastrointestinal tract
Gastrointestinal tract
The human gastrointestinal tract refers to the stomach and intestine, and sometimes to all the structures from the mouth to the anus. ....
, which includes the organs
Organ (anatomy)
In biology, an organ is a collection of tissues joined in structural unit to serve a common function. Usually there is a main tissue and sporadic tissues . The main tissue is the one that is unique for the specific organ. For example, main tissue in the heart is the myocardium, while sporadic are...
from mouth
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....
to anus
Anus
The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...
, along the alimentary canal, are the focus of this specialty. Physicians practicing in this field of medicine are called gastroenterologists. They have usually completed the eight years of pre-medical and medical education, the yearlong internship (if this is not a part of the residency), three years of an internal medicine residency, and two to three years in the gastroenterology fellowship. Some gastroenterology trainees will complete a "fourth-year" (although this is often their 7th year of graduate medical education) in Transplant Hepatology, Advanced Endoscopy, IBD, motility or other topics.
Gastroenterology is not the same as colorectal or hepatobiliary surgery, which are specialty branches of general surgery.
Hepatology
Hepatology
Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders. Etymologically the word Hepatology is formed of ancient Greek hepar or hepato- meaning ' liver' and suffix -logia meaning 'word' or 'speech'...
, or hepatobiliary medicine, encompasses the study of the liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
, pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...
, and biliary tree
Biliary tree
The biliary tract is the common anatomical term for the path by which bile is secreted by the liver then transported to the first part of the small intestine, also known as the duodenum...
, and is traditionally considered a sub-specialty.
History
Citing from EgyptianAncient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...
papyri
Papyrus
Papyrus is a thick paper-like material produced from the pith of the papyrus plant, Cyperus papyrus, a wetland sedge that was once abundant in the Nile Delta of Egypt....
, Nunn identified significant knowledge of gastrointestinal diseases among practising physicians during the periods of the pharaoh
Pharaoh
Pharaoh is a title used in many modern discussions of the ancient Egyptian rulers of all periods. The title originates in the term "pr-aa" which means "great house" and describes the royal palace...
s. Irynakhty, of the tenth dynasty, c. 2125 B.C., was a court physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
specialising in gastroenterology and proctology
Proctology
Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but the term is outdated in the more traditional areas of medicine...
.
Among ancient Greeks
Greeks
The Greeks, also known as the Hellenes , are a nation and ethnic group native to Greece, Cyprus and neighboring regions. They also form a significant diaspora, with Greek communities established around the world....
, Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
attributed digestion
Digestion
Digestion is the mechanical and chemical breakdown of food into smaller components that are more easily absorbed into a blood stream, for instance. Digestion is a form of catabolism: a breakdown of large food molecules to smaller ones....
to concoction. Galen
Galen
Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...
's concept of the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
having four faculties was widely accepted up to modernity in the seventeenth century.
Eighteenth century:
- ItalianItalyItaly , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
Lazzaro SpallanzaniLazzaro SpallanzaniLazzaro Spallanzani was an Italian Catholic priest, biologist and physiologist who made important contributions to the experimental study of bodily functions, animal reproduction, and essentially discovered echolocation...
(1729–99) was among early physicianPhysicianA physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s to disregard Galen's theories, and in 1780 he gave experimental proof on the action of gastric juice on foodstuffs. - In 1767, GermanGermanyGermany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
Johann von ZimmermannJohann Georg Ritter von ZimmermannJohann Georg Ritter von Zimmermann was a Swiss philosophical writer, naturalist, and physician.-Life and works:...
wrote an important work on dysenteryDysenteryDysentery is an inflammatory disorder of the intestine, especially of the colon, that results in severe diarrhea containing mucus and/or blood in the faeces with fever and abdominal pain. If left untreated, dysentery can be fatal.There are differences between dysentery and normal bloody diarrhoea...
. - In 1777, Maximilian StollMaximilian StollMaximilian Stoll was an Austrian physician who was a native of Erzingen, Baden-Württemberg. Stoll originally trained as a theologian, but switched to medicine, and in 1776 attained a chair at the University of Vienna. Soon afterwards, he succeeded Anton de Haen at the Vienna clinic...
of ViennaViennaVienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...
described cancer of the gallbladderGallbladderIn vertebrates the gallbladder is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated....
.
Nineteenth century:
- In 1805, Philipp BozziniPhilipp BozziniPhilipp Bozzini was born in Mainz, Germany. On June 12, 1797 he was awarded the degree of doctor of medicine. From 1804 onwards, Bozzini devoted himself virtually completely to develop his instrument, Lichtleiter or "Light Conductor", a primitive endoscope to allow for inspecting the ear, urethra,...
made the first attempt to observe inside the living human body using a tube he named Lichtleiter (light-guiding instrument) to examine the urinary tract, the rectumRectumThe rectum is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. The human rectum is about 12 cm long...
, and the pharynxPharynxThe human pharynx is the part of the throat situated immediately posterior to the mouth and nasal cavity, and anterior to the esophagus and larynx. The human pharynx is conventionally divided into three sections: the nasopharynx , the oropharynx , and the laryngopharynx...
. This is the earliest description of endoscopyEndoscopyEndoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...
. - Charles Emile TroisierCharles Emile TroisierCharles Emile Troisier was a French doctor.The following are named for him:* Troisier's sign, a hard, enlarged, left supraclavicular lymph node.* Troisier-Hanot-Chauffard syndrome, a form of diabetes mellitus-References:...
described enlargement of lymph nodeLymph nodeA lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
s in abdominal cancer. - In 1823, William ProutWilliam ProutWilliam Prout FRS was an English chemist, physician, and natural theologian. He is remembered today mainly for what is called Prout's hypothesis.-Biography:...
discovered that stomachStomachThe stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
juices contain hydrochloric acidHydrochloric acidHydrochloric acid is a solution of hydrogen chloride in water, that is a highly corrosive, strong mineral acid with many industrial uses. It is found naturally in gastric acid....
. - In 1868, Adolf Kussmaul, a well-known German physician, developed the gastroscope. He perfected the technique on a sword swallowerSword swallowingSword swallowing is an ancient performance art in which the performer passes a sword through the mouth and down the esophagus towards the stomach...
. - In 1871, at the society of physicians in Vienna, Carl StoerkKarl StoerkKarl Stoerk ; was an Austrian laryngologist who was a native of Ofen. He studied medicine at the Universities of Prague and Vienna, and received his doctorate in 1858. Afterwards he was an assistant to Ludwig Türck in Vienna, where he practiced medicine for the remainder of his career...
demonstrated an esophagoscope made of two telescopic metal tubes, initially devised by Waldenburg in 1870. - In 1876, Karl Wilhelm von KupfferKarl Wilhelm von KupfferKarl Wilhelm von Kupffer was a Baltic German anatomist who discovered stellate macrophage cells that bear his name....
described the properties of some liver cells now called Kupffer cellKupffer cellKupffer cells, also known as Browicz-Kupffer cells and stellate macrophages, are specialized macrophages located in the liver lining the walls of the sinusoids that form part of the reticuloendothelial system .-History:The cells were first observed by Karl Wilhelm von Kupffer in 1876...
. - In 1883, Hugo KroneckerHugo KroneckerKarl Hugo Kronecker was a German physiologist from Liegnitz, Prussian Silesia. He was the brother of Leopold Kronecker....
and Samuel James MeltzerSamuel James MeltzerSamuel James Meltzer was an American physiologist, born in Russia. He was educated at Konigsberg, Prussia, studied philosophy at and medicine at the University of Berlin ; and in the following year he emigrated to the United States, where he practiced his profession in New York City, serving as...
studied oesophageal manometryManometryManometry refers to the evaluation of pressure .Forms include:* Esophageal motility study* Anorectal manometry* Rhinomanometry...
in humans.
- In 1915, Jesse McClendonJesse Francis McClendonJesse Francis McClendon was an American chemist, zoologist and physiologist. He is remembered today mainly for the first pH measurement of human stomach in situ.Jesse F...
tested acidityGastric acidGastric acid is a digestive fluid, formed in the stomach. It has a pH of 1 to 2 and is composed of hydrochloric acid , and large quantities of potassium chloride and sodium chloride...
of human stomach in situIn situIn situ is a Latin phrase which translated literally as 'In position'. It is used in many different contexts.-Aerospace:In the aerospace industry, equipment on board aircraft must be tested in situ, or in place, to confirm everything functions properly as a system. Individually, each piece may...
. - In 1921-22, Walter AlvarezWalter C. AlvarezWalter Clement Alvarez was an American doctor of Spanish descent. He authored several dozen books on medicine, and wrote Introductions and Forewords for many others....
did the first electrogastrographyElectrogastrogramAn electrogastrogram is a graphic produced by an electrogastrograph, which records the electrical signals that travel through the stomach muscles and control the muscles' contractions...
research. - Rudolph SchindlerRudolph Schindler (doctor)Rudolf Schindler was a German physician, who practiced medicine as a gastroenterologist. He is regarded widely as the "father of gastroscopy."...
described many important diseases involving the human digestive system during World War IWorld War IWorld War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...
in his illustrated textbook and is portrayed by some as the "father of gastroscopy". He and Georg Wolf developed a semiflexible gastroscope in 1932. - In 1932, Burrill Bernard Crohn described Crohn's diseaseCrohn's diseaseCrohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms...
. - In 1957, Basil HirschowitzBasil HirschowitzBasil Isaac Hirschowitz is an academic gastroenterologist from the University of Alabama at Birmingham best known in the field for having invented an improved optical Fiber which allowed the creation of a useful flexible endoscope...
introduced the first prototype of a fibreoptic gastroscope.
Twenty-first century:
- In 2005, Barry MarshallBarry MarshallBarry James Marshall, AC, FRS, FAA is an Australian physician, Nobel Prize laureate in Physiology or Medicine, and Professor of Clinical Microbiology at the University of Western Australia. Marshall is well-known for proving that the bacterium Helicobacter pylori Barry James Marshall, AC, FRS, FAA...
and Robin WarrenRobin WarrenJohn Robin Warren AC is an Australian pathologist, Nobel Laureate and researcher who is credited with the 1979 re-discovery of the bacterium Helicobacter pylori, together with Barry Marshall.- Life and career :...
of Australia were awarded the Nobel Prize in Physiology or MedicineNobel Prize in Physiology or MedicineThe Nobel Prize in Physiology or Medicine administered by the Nobel Foundation, is awarded once a year for outstanding discoveries in the field of life science and medicine. It is one of five Nobel Prizes established in 1895 by Swedish chemist Alfred Nobel, the inventor of dynamite, in his will...
for their discovery of Helicobacter pyloriHelicobacter pyloriHelicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...
(1982/1983) and its role in peptic ulcer disease. James Leavitt assisted in their research, but the Nobel Prize is not awarded posthumously so he was not included in the award.
Disease classification
1. International Classification of Disease(ICDICD
The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...
2007)/WHO classification:
- Chapter XI,Diseases of the digestive system,(K00-K93)http://www.who.int/classifications/apps/icd/icd10online/
2. MeSH
Medical Subject Headings
Medical Subject Headings is a comprehensive controlled vocabulary for the purpose of indexing journal articles and books in the life sciences; it can also serve as a thesaurus that facilitates searching...
subject Heading:
- Gastroenterology (G02.403.776.409.405)http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?mode=&term=Gastroenterology&field=entry
- Gastroenterological diseases(C06.405)http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?mode=&term=Gastrointestinal+Diseases#TreeC06.405
3. National Library of Medicine Catalogue(NLM classification 2006):
- Digestive system(W1)http://wwwcf.nlm.nih.gov/class/class_wi.html#WI
Gastroenterological societies
- World Gastroenterology OrganisationWorld Gastroenterology OrganisationThe World Gastroenterology Organisation is an international professional medical federation of over 100 national GI societies and 4 regional associations of gastroenterology representing over 50,000 individual members....
- American College of GastroenterologyAmerican College of GastroenterologyThe American College of Gastroenterology is a Bethesda, Maryland-based medical association of gastroenterologists.The association was founded in 1932 and holds annual meetings and regional postgraduate continuing education courses, establishes research grants, and publishes The American Journal of...
- American Gastroenterological AssociationAmerican Gastroenterological AssociationThe American Gastroenterological Association "AGA" is a medical association of gastroenterologists. About 17,000 scientists and physicians are members of the organization.-Overview:...
- American Society for Gastrointestinal EndoscopyAmerican Society for Gastrointestinal EndoscopyThe American Society for Gastrointestinal Endoscopy, or ASGE, is a professional organization of physicians dedicated to improving endoscopy. The ASGE is made up largely of gastroenterologists from the United States. Included in its membership are endoscopists from other medical specialties as well...
- British Society of GastroenterologyBritish Society of GastroenterologyThe British Society of Gastroenterology is a British professional organisation of gastroenterologists, surgeons, pathologists, radiologists, scientists, nurses, dietitians and others amongst its members, which number over 3,000. It was founded in 1937, and is a registered charity...
Research Resources for Gastroenterology
- Annals of Gastroenterology & Hepatology - www.slm-gastroenterology.com (Published by San Lucas Medical www.slm-journals.com)
- Scandinavian Journal of GastroenterologyScandinavian Journal of GastroenterologyScandinavian Journal of Gastroenterology is a peer-reviewed medical journal covering the field of Gastroenterology.- Core topics :* Gastroenterology* Hepatology* Aspects of digestive organs within surgery and internal medicine...
(SGAS)
See also
Annals of Gastroenterology & Hepatology - www.slm-gastroenterology.com (Published by San Lucas Medical www.slm-journals.com)- Gastroenterology (journal)Gastroenterology (journal)Gastroenterology is the official medical journal of the American Gastroenterological Association. Its first issue was published in 1943. It is currently published by Elsevier. According to the Journal Citation Reports, the journal has a 2010 impact factor of 12.032, ranking it first out of 71...