What tests can I expect to see a gastroenterologist for?

Gastroenterology is unfamiliar territory for many people, and understandably so. If you're wondering what to expect in a gastroenterologist's office, this article will help you navigate the most common tests and understand why they're necessary.

Gastroenterology is concerned with diseases of the digestive system - including the oesophagus, stomach, small and large intestines, liver, bile and pancreas. When you consult your doctor with digestive complaints, the specialist may order various tests to pinpoint the cause of the problem and plan the appropriate treatment.

When should you see a gastroenterologist?

Several symptoms may indicate that you should have a gastroenterological examination. These include:

• Difficulty swallowing or painful swallowing: If you feel that food gets stuck in your throat or it hurts to swallow.
• Stomach and intestinal disorders: Persistent heartburn, bloating, abdominal pain or Crohn's disease.
• Chair-related problems: Bloody stools, persistent diarrhoea or constipation, or sudden changes in bowel movements.
• Weight loss and loss of appetite: If you lose weight or appetite unduly.
• Anaemia: If the blood test shows iron deficiency or anaemia.
• Recurrent vomiting: Especially if it does not go away or is of unknown origin.

These symptoms can indicate a wide range of conditions, so it is important to be seen by a specialist.

Laboratory tests

Laboratory tests are often the first step in a gastroenterological investigation. These tests help to detect inflammatory processes, anaemia or other abnormalities.

Blood test

During the blood test, the doctor may check several different values:

• Blood count: It will show whether there is anaemia or signs of inflammation.
• Mayenzim: They are used to monitor liver function (AST, ALT, alkaline phosphatase).
• Bilirubin: To identify the problems behind jaundice.
• Coagulation values: To monitor the synthetic function of the liver.
• Specific antibodies: For example to detect celiac disease or autoimmune liver diseases.

Stool analysis

Taking a stool sample may help:

• Detecting hidden (occult) bleeding: Even if the bleeding is not visible to the naked eye.
• Measure inflammatory markers: For example, measuring faecal calprotectin in suspected inflammatory bowel disease (IBD).
• To detect infections: To detect bacterial, viral or parasitic infections.

Urinalysis

In some cases, a urine test may also be useful, especially if a problem with pancreatic function is suspected.

Imaging studies

Imaging techniques allow the doctor to „peer” into the digestive tract without the need for invasive surgery.

Abdominal ultrasound

An ultrasound scan is a simple, painless and quick way to look at abdominal organs such as the liver, gall bladder, pancreas and kidneys. It can be used to detect:

• Liver diseases (fatty liver, cirrhosis)
• Gallstones
• Pancreatitis
• Fluid retention in the abdomen (ascites)

Ultrasound usually requires no preparation, although in some cases you may need to come on an empty stomach.

CT (computed tomography) and MRI (magnetic resonance imaging)

These tests give a more detailed picture of the abdominal organs and are particularly useful:

• Detection of tumours
• Accurate localisation of inflammatory processes
• Detection of vascular abnormalities

MRCP (Magnetic Resonance Cholangiopancreatography) is a special MRI scan that gives a detailed picture of the ducts of the pancreas and the pancreas.

Endoscopic examinations

During endoscopic examinations, the doctor inserts a thin, flexible tube (endoscope) into the body, through which he or she can directly view the inner surface of the digestive tract. Although many patients are concerned about these tests, they are usually well tolerated and provide valuable information.

Gastroscopy (upper gastrointestinal endoscopy)

During a gastroscopy, the doctor examines the oesophagus, stomach and the first part of the duodenum.

When is it needed?

• Difficulty swallowing
• Heartburn or reflux
• Suspected stomach ulcer
• Bleeding or anaemia
• Detection of stomach cancer

How to prepare?

You should not eat 6-8 hours before the test. The test is performed under general anaesthesia.

What are the risks?

Gastroscopy is usually safe, but rare complications can occur, such as bleeding, perforation (a breach in the wall) or aspiration (when fluid is released into the airways).

Colonoscopy (colonoscopy of the colon)

During a colonoscopy, the doctor examines the entire colon and the end of the rectum.

When is it needed?

• Bloody stools or anaemia
• Persistent diarrhoea or constipation
• Abdominal pain of unknown origin
• Colorectal cancer screening (recommended over 50 years)
• Removal of polyps

How to prepare?

Preparation for a colonoscopy requires a thorough bowel evacuation. This means taking a special laxative the day before the test to cleanse the bowel. You will be given a sedative during the test, so you will not usually feel any pain.

What are the risks?

Colonoscopy is also a safe procedure, but in rare cases, bleeding or perforation may occur, especially if a polyp is removed.

Enteroscopy (small intestine endoscopy)

Enteroscopy is used to examine the small intestine, which is a more difficult area to reach. This is necessary when gastroscopy and colonoscopy have not provided an answer to the problem, for example in the case of hidden bleeding.

Capsule endoscopy

Capsule endoscopy is a modern, non-invasive method in which the patient swallows a small capsule with a camera. The capsule passes through the digestive tract, taking images that are later evaluated by the doctor.

When is it needed?

• Finding the source of hidden bleeding
• Suspected small bowel disease (e.g. Crohn's disease)
• Detection of small bowel tumours

How to prepare?

You should be on an empty stomach before the test and usually only drink liquids on the day of the test. The capsule is naturally eliminated from the body within a few days.

Chromoendoscopy and advanced imaging methods

Modern endoscopy also uses special techniques to help detect subtle lesions, such as early tumours or precancerous conditions:

• NBI (Narrow Band Imaging): Special light filtering that highlights vascular patterns.
• Chromoendoscopy: Use of dyes to improve the appearance of the mucosa.
• Confocal laser endomicroscopy: Microscopic resolution imaging during the study.

Functional tests

In some cases, the digestive system needs to be examined, not just structural abnormalities.

Esophageal manometry

This test measures the function of the muscles of the oesophagus and helps diagnose swallowing disorders such as achalasia or diffuse oesophageal spasm.

Gastric emptying scintigraphy

This test measures how quickly the contents of the stomach are emptied. It is used when gastroparesis (slow gastric emptying) is suspected.

24-hour pH monitoring

Used to diagnose reflux disease. A thin probe is inserted into the oesophagus and measures acidity for 24 hours.

Special tests and interventions

ERCP (endoscopic retrograde cholangiopancreatography)

ERCP is used to examine and treat the ducts of the biliary tract and pancreas. It can be used to:

• For removing gallstones
• To widen bottlenecks
• Stenting

EUH (endoscopic ultrasound)

Endoscopic ultrasound combines the advantages of endoscopy and ultrasound. It helps:

• The pancreas can be examined in detail
• The exact extent of tumours can be determined
• Tissue samples can be taken from deeper layers

Elastography

Elastography measures the stiffness of the liver and helps to determine the extent of liver fibrosis (scarring). This is particularly important in chronic liver diseases such as hepatitis or fatty liver.

How does a gastroenterology examination work?

First test

During the first visit, the doctor takes a detailed medical history and performs a physical examination. Symptoms, family history and previous illnesses are discussed. The doctor will then decide what further tests are needed.

Test plan

The order and type of tests depend on the symptoms and the suspected diagnosis. Usually, the less invasive tests are started (blood tests, ultrasound) and, if necessary, more complex procedures (endoscopy, CT) are performed.

Results and treatment

Once all the necessary tests have been done, your doctor will discuss the results with you and plan your treatment. This could be drug therapy, lifestyle changes or even surgery, depending on the diagnosis.

Frequently asked questions (FAQ)

Are the tests painful?

Most gastroenterology tests are not painful. Endoscopic examinations can be uncomfortable but are well tolerated with anaesthetics.

How long does an endoscopic examination take?

A gastroscopy or colonoscopy usually takes 15-30 minutes. Preparation and wake-up times are added, so allow about 2-3 hours for the entire examination.

Do I need an escort for the test?

If you are sedated during the test, you will need someone to accompany you home. You will not be able to drive a car or operate heavy machinery for a few hours because of the effects of the sedatives.

How often should the tests be repeated?

It depends on what the diagnosis is. For example, in the case of colorectal cancer screening, if there are no abnormalities, it is sufficient to repeat a colonoscopy every 10 years. If polyps are found, then more frequent scans - even every year - may be necessary.

How much do the tests cost?

For patients with a social security card, most basic gastroenterological examinations are free of charge within the framework of social insurance. However, some special tests may be subject to a fee. For private patients, all tests are free of charge.

Is there an alternative to endoscopic examinations?

In some cases, yes. For example, capsule endoscopy can be a non-invasive alternative to conventional endoscopy. However, in many cases endoscopy is essential because it allows tissue sampling and treatment.

How to prepare for the tests?

Before gastroscopy

• Do not eat 6-8 hours before the test.
• If necessary, stop taking medicines that have not been in your blood (always consult your doctor).
• Take a chaperone with you if you are sedated.

Before colonoscopy

• Follow special dietary requirements (usually a low-fibre diet a few days before the test).
• Take the bowel preparation as directed.
• Do not eat solid food on the day of the test.
• Take an accompanying person.

Before an ultrasound scan

• Arrive on an empty stomach (usually 6-8 hours of fasting is required).
• Do not drink fizzy drinks before the test.

What can you do after the test?

After gastroscopy

• If you have been sedated, rest for a few hours.
• Don't drive a car or make important decisions that day.
• A slightly rough throat or bloating may be normal, but will go away within a few days.

After colonoscopy

• Take a rest, because defecation can be tiring.
• Eat simple, easily digestible foods.
• It's normal if you feel bloated, it will go away.

When should you see a doctor after the test?

If you experience the following symptoms, contact your doctor immediately:

• Severe abdominal pain
• Fever
• Bleeding (bloody vomit or stools)
• Shortness of breath or chest pain

Summary

Gastroenterological investigations are key to the early detection and treatment of digestive diseases. Although they may seem daunting to many, modern medicine offers safe and effective methods that allow rapid diagnosis and appropriate treatment.

If you are also suffering from gastrointestinal problems, do not delay seeking medical advice. Problems caught early are much easier to treat, and the information you gain from tests will help you regain your health and quality of life.

From Endomedix team is committed to helping patients with modern equipment and expert doctors. If you have any questions about the tests, please do not hesitate to contact our specialists who will be happy to help you.