What is a gastroenterologist and what does he do? (2023)

If you experience severe or ongoing digestive problems, your healthcare provider may refer you to a specialized provider called a gastroenterologist. Sometimes called gastrointestinal or GI doctors, these health care providers are experts in the digestive system.

Before going to see a gastroenterologist, it's important to understand what conditions these providers treat, the procedures they perform, and what to expect from your first appointment.

Gastroenterologists are specialists who focus on diagnosing and treating conditions that affect the gastrointestinal tract, or GI tract.

The GI tract includes the organs you use to swallow, digest, absorb, and empty the food and drink you consume.That means gastroenterologists can help manage conditions that affect:

• Esophagus
• Stomach
• Small intestine
• Colon
• GOOD

Gastroenterologists can also help monitor conditions in other organs involved in the digestive process, including:

• Pancreas
• Gallbladder
• bile ducts
• Liver

Gastroenterologists may perform imaging tests, analyze blood and stool test results, and ask about symptoms to make a diagnosis. They can then prescribe medications, order follow-up tests, and monitor symptoms to manage any diagnosed conditions.

When should I see a gastroenterologist?

There are several reasons why you might need to see a gastroenterologist. You may need to get an opinion on the symptoms you're experiencing, undergo diagnostic or preventative tests, or keep up with follow-up for a condition you've already been diagnosed with.

Unless you are already an established patient of a gastroenterologist for a chronic condition, your primary care provider can tell you when to see a gastroenterologist based on your symptoms, any current conditions, and your medical history.

To check persistent symptoms

Sometimes occasional digestive problems, like a bout of food poisoning, can be managed on your own or with the help of a primary care doctor. Persistent or certain symptoms may require the expertise of a gastroenterologist.

Common symptoms that require a referral to a gastroenterologist include:

• Difficulty swallowing (dysphagia)
• Persistent nausea and vomiting
• stomach and/or abdominal pain
• Acidity
• Diarrhea
• Constipation
• Signs of jaundice, including yellowing of the skin and eyes.
• Loss or sudden weight gain
• Blood in the stool

The gastroenterologist can determine what is causing the symptoms.

To control gastrointestinal conditions

Gastroenterologists can provide long-term treatment for conditions that affect each part of the gastrointestinal tract or organs related to the digestive process.

Common conditions of the esophagus, which is the tube that connects the throat and stomach, include:

• Gastroesophageal reflux disease (GERD):A condition that develops when stomach acids flood the esophagus
• Barrett's esophagus:A change in the lining of the lower portions of the esophagus.
• esophagitis:A persistent inflammation and irritation of the esophagus.
• Hernia hiatal:A condition that occurs when the stomach pushes through the diaphragm, the thin layer of tissue that separates the chest from the abdomen.

Gastroenterologists treat conditions, such as a food allergy or bacterial overgrowth in the small intestine, that affect the health of the stomach and intestines. Other common intestinal conditions that gastroenterologists can treat are:

• Gastritis:An inflammation of the stomach lining.
• diverticulitis:An inflammation of small pouches in the intestines.
• Celiac Disease:An immune reaction to eating gluten (wheat)
• Irritable bowel syndrome (IBS):Bloating and swelling in the stomach or intestines
• Inflammatory bowel disease (IBD):Crohn's diseaseoulcerative colitis, two conditions marked by inflammation in the GI tract
• Appendicitis:An infection of the appendix
• Hemorrhoids:Swollen veins in the anus or rectum
• Certain types of cancer:These include cancers of the colon, rectum, intestines, or stomach.

Gastroenterologists can also monitor conditions that affect the liver, including:

• Hepatitis:An inflammation of the liver, which can be caused by a viral infection or damage due to drug or alcohol use.
• Fatty liver disease:Excess fat stored in the liver
• Cirrhosis:Late-stage liver disease caused by hepatitis, excessive alcohol use, or fatty liver disease

Gastroenterologists can diagnose and treat conditions that affect the gallbladder, such as:

• gallstones:Hardened collections of bile within the gallbladder
• Cholecystitis:An inflammation of the gallbladder often due to gallstones
• Pancreatitis:An irritation and inflammation of the pancreas due to the use of alcohol or gallstones

For routine exams

Many people visit a gastroenterologist to screen for colorectal cancer, which is cancer that develops in the colon (large intestine) or rectum.

During a screening test, the gastroenterologist will examine the colon and rectum for polyps (extra growths of tissue that are usually not cancer but can become cancer) and other abnormal growths.

There are several tests to detect colorectal cancer, including different imaging tests, such as a sigmoidoscopy orcolonoscopy.

There is also a virtual colonoscopy, in which X-ray equipment is used to take pictures of the entire colon and rectum from outside the body. The gastroenterologist will review these images to determine if a standard colonoscopy is needed.

A gastroenterologist may also order a stool test, for which you would send a stool (poop) sample to the gastroenterologist, and they will test small amounts of blood for possible polyps.

Getting regular screenings can help prevent colorectal cancer from developing or help find cancer early so it's easier to treat. In both a sigmoidoscopy and a colonoscopy, the gastroenterologist can remove polyps during the exam, which can prevent them from becoming cancerous.

The recommendation for colorectal cancer screening is to start at age 45 and continue to be screened every five to 10 years, depending on the test. If you have any risk factors, such as IBD or a family history of colorectal cancer, you may need to start getting tested early and more often.

Because they have experience with a wide range of conditions, gastroenterologists perform many types of procedures for diagnosis, monitoring, treatment, and screening. The most common of these procedures are:

Esophageal endoscopy:In this procedure, often called an upper endoscopy, gastroenterologists insert a thin, flexible, lighted tube with a camera, or endoscope, down the throat and esophagus, accessing the stomach and small intestine. This allows them to visually examine these areas.

Sigmoidoscopia:The sigmoid is a portion of the lower part of your colon. When a gastroenterologist needs to look at and evaluate the sigmoid, he will insert a type of endoscopic device called a sigmoidoscope through the rectum into the colon. This procedure can be done with a flexible tube (flexible sigmoidoscopy) or a rigid tube (rigid sigmoidoscopy).

Colonoscopy:For the test, the doctor will insert an endoscopic device into the rectum to examine the rectum and entire colon for signs of inflammation, cancer, or other growths.

Polypectomy:A minimally invasive alternative to abdominal surgery, polypectomy is the removal of polyps (abnormal growths) from the colon performed with the aid of a sigmoidoscopy or colonoscopy. Polyps can be removed with forceps or burned with a surgical device called a trap.

Dilatation:Performed in either the esophagus (esophageal dilation) or intestines (intestinal dilation), this procedure slightly stretches the area to relieve symptoms of inflammation and narrowing within the tube.

hemostasis:Using endoscopy, this procedure treats internal bleeding, often in the upper gastrointestinal tract, by injection of a special substance, application of heat, or a hemoclip (a type of clamp worn temporarily).

Endoscopic biliary examination:This endoscopic procedure allows gastroenterologists to view and evaluate the biliary tract, which is the liver, gallbladder, and bile ducts. It is also known as endoscopic retrograde cholangiopancreatography (ERCP).

Endoscopic mucosal resection (EMR):This endoscopic procedure is used to remove cancerous, precancerous, or other abnormal tissue from the esophagus, stomach, intestines, or rectum.

Stent placement:Gastroenterologists can use endoscopic procedures to place hollow tubes called stents, which can help expand or open up a blocked section of intestine. Stenting can help treat blockages in the digestive tract.

Endoscopic ultrasound (EUS):Also known as echoendoscopy, EUS combines endoscopy with ultrasound imaging to assess the health of the gastrointestinal tract.

Tips for your first date

Going to see a specialist like a gastroenterologist for the first time can be different from a routine visit to a general health care provider. Here's what to expect at your first visit and some ways to prepare for your appointment.

what to expect

The first appointment with a gastroenterologist usually lasts between 30 minutes and an hour. The doctor will ask about your medical status and history and discuss your symptoms with you.

In addition, the doctor will perform a physical exam. This test may involve:

• visual observation:The doctor will look at your abdomen to check for abnormal growths or other problems.
• Auscultation:This is a diagnostic procedure in which the doctor uses a stethoscope to listen to the sounds made by the intestines or abdomen.
• Palpation:The gastroenterologist will feel around all four quadrants of your abdomen to check for any abnormal growths, pain, or tenderness in any area. You may be asked to take a deep breath or cough during the test.
• Rectal exam:The doctor may need to insert a finger into the rectum to look for abnormal growths, masses, or signs of inflammation.

If more tests are needed, such as a colonoscopy, the provider will ask you to schedule a different time to do that procedure. Before any follow-up procedure, the office will give you guidance on how to prepare.

As with any type of appointment, it is important to be prepared if you have been referred to a gastroenterologist. Having certain information with you can help the doctor make a diagnosis.

Know your medical history

Many medical offices will ask you to upload your medical information to an online portal prior to your appointment, but you may also be asked to discuss this in person during your appointment. Come prepared to discuss any conditions you currently have or have had in the past, as well as any previous treatments or procedures you have received.

The doctor will also ask what medications you are taking if you have allergies and a family history of the disease. The more the provider knows about your medical condition and history, the better they can identify and treat your condition.

Keep track of your symptoms

It is important that your gastroenterologist has an idea of ​​how you are feeling and what your symptoms are. Before your appointment, keep a record of your symptoms, including any over-the-counter medications or home methods you have taken to control your symptoms. It may also help to keep track of your diet. Bring these notes with you to your appointment so you can discuss them with your doctor.

Send the results of any tests in advance

The gastroenterologist will likely want to review the results of any relevant medical tests or evaluations, such as imaging, stool tests, and blood tests. This includes any test results related to chronic conditions you may have, such as diabetes or IBD. You can usually have your primary care provider or testing center send them directly to the gastroenterologist's office.

Prepare a list of questions

During your appointment, it will be important to learn as much as you can about your condition and possible treatments. You can also ask about your GI doctor's experience. Here are possible questions to ask your GI doctor:

• What may be causing my symptoms?
• What tests should I take? How can I prepare for them?
• How serious is my condition?
• What are my treatment options?
• How many times have you performed this procedure?
• How is the recovery from my treatment?
• What will follow-up or additional care be like?
• What kind of dietary adjustments or lifestyle changes should I make?
• How long have you been practicing gastroenterology?

Education and Training Requirements for Gastroenterologists

As with all medical specialists, gastroenterologists receive specific training after medical school. After completing medical school, gastroenterologists spend an additional five to six years of gastroenterology training before they can practice independently.

The training of gastroenterologists is as follows:

Medicine School

All physicians must graduate from medical school before entering their specific field or specialty. In medical school, students will study advanced biomedical sciences and clinical skills and may begin working with patients through clinical rotations. These programs typically last four years, with graduates receiving a doctor of medicine (MD) or doctor of osteopathic medicine (DO) degree upon completion.

Residency in Internal Medicine

The next step is a residency in internal medicine. Residency is typically a rigorous three-year program in which residents (graduate medical students) work and learn under the supervision of specialists and gain a foundation of medical practice.

All medical specialists, including gastroenterologists, must complete a residency program.

Fellowship

After residency, a gastroenterologist receives focused training in their field through a gastroenterology fellowship program. A scholarship is a continuous specialized training that can last from two to three years. Under the direction of board-certified GI specialists, medical students learn to diagnose and care for people with gastroenterological diseases.

During their fellowship, gastroenterologists receive training in procedures such as endoscopy and polypectomy.

Board Certification

National organizations such as the American College of Gastroenterology and the American Gastroenterological Association set guidelines for the training of gastroenterologists.

Upon completion of their fellowships, gastroenterologists are deemed "board eligible" and take a certification exam administered by the American Board of Internal Medicine. After passing the exam, the gastroenterologist is considered "board certified."

Subspecialization

Following their residency and fellowships, gastroenterologists may choose to receive additional training in specific subspecialties of the field. For example, after an additional one-year program, gastroenterologists may specialize in hepatology, which focuses on conditions that affect the liver. Other subspecialties include:

• interventional endoscopy
• EII
• gastrointestinal cancer
• pancreatic disease
• Transplant
• functional bowel disease
• Reflux esophagitis (inflammation of the esophagus, the tube that leads from the throat to the stomach)

Gastroenterologists are highly trained specialists in the gastrointestinal tract, as well as other organs involved in the digestive process. Gastroenterologists can diagnose and manage diseases that affect the esophagus, stomach, upper and lower intestines, gallbladder, liver, and rectum. When it's time to be screened for colon cancer, you'll need to see a gastroenterologist. You may also be referred to a gastroenterologist if you experience certain symptoms. During this initial appointment, be prepared to discuss your symptoms and medical history. The gastroenterologist will decide the next best step, which may be imaging tests. If you are diagnosed with a GI condition, you will likely need to return to the gastroenterologist for a follow-up checkup.