Gastroenterologist in Latviawhere to get treatment, how to verify certification, what this doctor does

A gastroenterologist diagnoses and treats disease of the digestive tract, liver, gallbladder and pancreas. A certified gastroenterologist in Latvia also performs basic endoscopy themselves, meaning upper gastrointestinal endoscopy and ileocolonoscopy, as well as abdominal ultrasound.

• Gastro-oesophageal reflux disease
• Inflammation and ulcers of the stomach and duodenum
• Functional disorders of the digestive tract
• Biliary and liver disease
• Persistent abdominal pain, nausea, vomiting
• Constipation, diarrhoea or changing bowel habit, blood or mucus in the stool

A family doctor is enough for short-lived digestive upsets. A gastroenterologist is needed when symptoms last weeks, when weight falls with no clear cause, when there is blood in the stool, or when endoscopy is required.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Residency in gastroenterology. The RSU programme runs 5 years, 330 ECTS, tuition 5,800 EUR per year, led by Ilona Vilkoite. Programme page: RSU residency programme.
• The programme combines gastroenterology modules, namely therapeutic gastroenterology, digestive endoscopy, hepatology and infection, and paediatric gastroenterology, with broader internal medicine modules.
• During residency the doctor must learn basic endoscopy and abdominal ultrasound.
• The state examination has 100 test questions with a 70 per cent pass mark, defence of a research project, and requires at least one presentation at a professional meeting and one publication at national level or above.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• Languages. Consultations run in Latvian and Russian, with some doctors also working in English.
• Endoscopy on site. If gastroscopy or colonoscopy is likely, check whether the provider performs it and whether sedation or anaesthesia is available.
• Appointment length. Price lists show scheduled consultations running 30 to 45 minutes, with follow-ups shorter.
• Children and adults. Some gastroenterologists see both, but paediatric gastroenterology is a separate specialty.
• Second opinion. Patients may freely choose the doctor and institution. With a valid referral, a state-funded consultation can be taken at any provider delivering that service from state funds.

• Bring the results of earlier investigations, including endoscopy reports and histology results, hospital discharge summaries, and a full list of medicines.
• Imaging reports also help: abdominal ultrasound, CT or MRI.
• At the first visit the doctor takes the history, examines the patient, and draws up an investigation plan, which is discussed with the patient.
• Endoscopy usually happens at a separate appointment and requires preparation beforehand. The provider issues the preparation instructions.
• Histology results are usually ready within one to two weeks and go to the doctor who ordered the test.

In the public system, with a referral, a specialist visit costs 4.00 EUR, an endoscopic examination 7.00 EUR, and an ultrasound 4.00 EUR. Where tests are ordered following state cancer screening, including bowel cancer screening, no patient co-payment applies. Co-payments in one calendar year are capped at 570.00 EUR.

• Gastroenterology consultationPrice EUR: 32.00Provider: Veselības centru apvienība
• In-person gastroenterology consultation, 30 minPrice EUR: 80.00Provider: Dr. Zane Straume's practice
• In-person gastroenterology consultation, up to 60 minPrice EUR: 120.00Provider: Dr. Zane Straume's practice
• Remote gastroenterology consultation, 30 minPrice EUR: 70.00Provider: Dr. Zane Straume's practice
• Scheduled gastroenterology consultation, 40 minPrice EUR: 118.20Provider: Premium Medical
• Repeat gastroenterology consultation, 20 minPrice EUR: 93.10Provider: Premium Medical
• Patient co-payment for a specialist visitPrice EUR: 4.00Provider: NVD
• Patient co-payment for an endoscopic examinationPrice EUR: 7.00Provider: NVD

The specialty body is the Latvian Association of Gastroenterologists, address Skolas iela 3, Rīga, LV-1010, contact Aldis Puķītis, website latvijasgastroenterologi.lv. It has no separate registration number: in the professional association data it is listed as a division of the Latvian Medical Association rather than an independent society.

Paediatric gastroenterology is represented by a separate association, "Latvijas Pediatru gastroenterologu asociācija", registration number 40008062672.

Certificates are issued by the Certification Council of the Latvian Medical Association, founded in 1988. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of care, raise them first with the institution's management, which must operate a complaints and suggestions system. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.