Continuation of treatment
At the repeat visit, therapy becomes targeted: histology and tests confirm/exclude Helicobacter and control is prescribed 4–6 weeks after the course; Based on the results of colonoscopy, follow-up after polypectomy is planned; Doses of PPIs, enzymes, and drugs for IBS are adjusted. Chronic patients (GERD, pancreatitis, hepatitis) receive a schedule of dispensary visits and tests.
Indications
- heartburn, belching, epigastric pain, heaviness after eating;
- pain along the intestines, bloating, constipation/diarrhea, blood in the stool;
- nausea, bitterness in the mouth, changes in liver function tests, jaundice;
- Helicobacter, gastritis, ulcer, GERD, IBS, pancreatitis - diagnosis and management;
- preparation for endoscopy and observation after polypectomies.
Diagnostic approach
The gastroenterologist builds a diagnosis from complaints to an accurate diagnosis: “alarming symptoms” (weight loss, anemia, blood, night pain, age 45+ with new symptoms) - a direct indication for endoscopy; for typical dyspepsia - testing and eradication of Helicobacter; for reflux - PPI test and decision on EGDS. Gastro- and colonoscopy with sedation and polypectomy (pages in this section), ultrasound and a full laboratory range are also available here - the examination is completed in one place in 1-2 visits.
