Gastrointestinal Pathology

What Is Gastrointestinal Pathology?

Gastrointestinal pathology is a medical sub-specialty focusing on diagnosing diseases of the gastrointestinal (GI) system, pancreas, and liver.

A gastrointestinal pathologist is a type of doctor with highly specialized training who examines tissue samples from the GI tract and related organs to diagnose disease. Gastrointestinal pathologists typically work in a laboratory, not directly with patients.

The tissue samples come from biopsies taken during endoscopic procedures like colonoscopy or enteroscopy.

What Do Gastrointestinal Pathologists Do?

Gastrointestinal pathologists use different types of microscopes and other specialized tools and tests to examine tissue samples for signs of disease.

They have extensive schooling and training to identify cancers, degenerative diseases, infectious diseases, immune system disorders, tumors, and more.

Tissue samples may be taken from the esophagus, stomach, small and large intestines, rectum, pancreas, liver, or bile ducts.

What Types of Diseases Do Gastrointestinal Pathologists Diagnose?

A gastrointestinal pathologist is an expert in diagnosing conditions like:

• Barret’s esophagus
• Celiac disease
• Chronic hepatitis
• Cirrhosis
• Colorectal polyps and cancer
• Crohn’s disease
• Fatty liver disease
• Gastroesophageal reflux
• H. pylori gastritis
• Pancreatitis
• Cancers affecting the gastrointestinal tract, liver, and pancreas
• Ulcerative colitis

Techniques to Identify Gastrointestinal Conditions

After tissue samples are obtained and processed, a gastrointestinal pathologist uses specialized techniques, tools, and processes to investigate their condition.

Some methods and tools they use include:

Stains – Chemicals or stains can be applied to tissue samples to highlight signs of disease or cell abnormalities. Different stains are used to identify different characteristics of the specimen.

Direct immunofluorescence – A special type of staining that helps identify autoimmune diseases.

Frozen section – A sample can be frozen and examined at once if a diagnosis is needed quickly, like during surgery.

Immunohistochemistry – This technique uses the body’s own antibodies to help identify the interaction between the antibodies and antigens triggering the immune system.

Electron microscopy – A special type of microscope that uses a beam of electrons instead of light, which allows pathologies to examine cell structures not otherwise visible.

Flow cytometry – A technique of analyzing the identity and quantity of a type of cell or particle. Samples are suspended in fluid and passed through different light sources, lenses, and filters to generate wavelength data. Flow cytometry can measure characteristics like cell size, total DNA, and more.

What Do Results Look Like?

The results of a gastrointestinal pathological examination are documented in a biopsy or pathology report, which includes information like:

• A diagnosis
• A description of the tissue sample
• What the sample looked like under the microscope
• Clinical information that helped support the diagnosis
• Additional information to help determine treatment
• If cancer is found, it may also contain information like what type
• Comments from the gastrointestinal pathologist

The report is sent to the treating doctor, who will discuss the results with the patient.