Gastroenterology in Baden-Baden

Gastroenterology deals with diseases of the esophagus, stomach, intestines, liver, bile ducts and pancreas. Complaints are often non-specific - all the more important is a structured clarification that clinically meaningfully categorizes findings and derives a clear diagnosis and therapy recommendation from them.

Qualification

European Gastroenterologist

Typical complaints

• Abdominal pain, pressure or feeling of fullness, nausea
• Heartburn/reflux, swallowing difficulties, unclear upper abdominal complaints
• Diarrhea, constipation, changing bowel habits
• Bloating, food intolerance (investigation instead of "self-diagnosis")
• Unclear laboratory findings (e.g. liver values, inflammation values, iron deficiency)

Focus areas

• Reflux disease, gastritis, irritable stomach
• Irritable bowel - only after differential diagnostic clarification
• Chronic inflammatory bowel diseases (CED) - ulcerative colitis / Crohn's disease
• Liver diseases including fatty liver and fibrosis diagnosis
• Gallbladder diseases / gallstones
• Diseases of the pancreas
• Small intestine diagnostics including capsule endoscopy - with clear question
• Allergy and intolerance diagnostics - cleanly differentiated

Diagnosis - structured and targeted

The goal is not "everything at once", but a clear question and a diagnosis that is therapeutically relevant.

1) Sonography (ultrasound)

• Upper abdominal sonography: liver, bile ducts, pancreas, spleen
• Sonography including color Doppler/color duplex depending on the question
• Liver elastography (shear wave technology) for non-invasive fibrosis assessment - similar to FibroScan (methodologically different)
• Follow-up checks for known findings

2) Laboratory, stool, allergy and intolerance diagnostics

• Inflammation parameters and organ laboratory (including liver and pancreas values)
• Stool examinations (e.g. calprotectin depending on the question)
• Investigation of iron deficiency/anemia, malabsorption and deficiency conditions (indication-based)
• Investigation of food allergies (IgE-mediated; depending on the question)
• Investigation of food intolerances (e.g. lactose/fructose; possibly hydrogen breath test after indication)
• Differentiation from functional causes (e.g. irritable bowel) - only after excluding relevant findings

3) Endoscopic diagnosis - if medically sensible

• In case of corresponding indication, endoscopic diagnosis (e.g. gastroscopy/colonoscopy) may be sensible
• Biopsies and finding interpretation are carried out in accordance with guidelines and question-related
• Invasive diagnostics/interventions are carried out in case of indication in specialized centers with which we are closely networked

4) Small intestine diagnostics / capsule procedure (capsule endoscopy) - in our practice

In case of special questions, small intestine diagnostics may be sensible (e.g. unclear bleeding, unclear iron deficiency anemia, selective questions in CED). We carry out the capsule endoscopy in the practice. It does not replace classical endoscopy, but supplements it in a targeted manner.

When a prompt clarification is recommended

• Blood in the stool, tarry stool or newly occurring anemia
• Unintended weight loss, persistent fever or significant night sweats
• Severe or increasing pain, repeated vomiting, swallowing difficulties
• Newly occurring, persistent diarrhea or nocturnal complaints
• Persistently elevated liver values or jaundice (icterus)

Medical classification instead of actionism

Not every finding is in need of treatment - and not every complaint needs "the next examination" immediately. The goal is a realistic classification that creates security and enables a effective, well-tolerated therapy - without unnecessary diagnostics.

Therapy and individual recommendations

Treatment is based on findings, complaints and risk profile and includes - depending on the indication -:

• Medicinal therapy (e.g. reflux therapy, anti-inflammatory, symptom-oriented strategies) - indication-based
• Nutritional medicine advice (not "diet trends", but medically sensible)
• Follow-up checks and course evaluation (laboratory, sonography, stool parameters depending on the question)
• In case of complex findings: targeted forwarding/cooperation with specialized centers

A key focus is liver diagnostics - see also our hepatology

Appointment & contact

If you would like to have complaints in the area of stomach, intestines or liver clarified, please make an appointment. Bring any existing findings (laboratory, preliminary findings, medication list) if possible.