Gastroenterologist

What is a gastroenterologist?

A gastroenterologist is a medical doctor who specializes in conditions affecting your digestive system. Gastroenterologists begin as general physicians. They complete three years of medical residency after medical school, treating all kinds of diseases and conditions. To become gastroenterologists, they complete three years of additional study after that. Then they receive a special certification. This certification designates them as experts in gastrointestinal diseases and conditions. It also qualifies them to perform certain exams and procedures that general physicians don’t, and to interpret the results.

What is a pediatric gastroenterologist?

A pediatric gastroenterologist is a pediatrician first, with extra training in gastroenterology. Pediatricians spend their three years of medical residency practicing general pediatric medicine, treating babies, children and teens for all kinds of conditions. Pediatric gastroenterologists study for three more years after that to earn their certification. They study the gastrointestinal and liver conditions that are most relevant to growing children, with a special emphasis on nutrition. They learn how to interpret children’s signs and symptoms and how to perform exams and minor procedures inside their smaller bodies.

What part of the body does a gastroenterologist focus on?

The name, gastroenterologist, refers to your stomach and intestines. (“Gastro” means stomach, “entero” means intestines and “ologist” means specialist.) These are the organs most commonly involved in gastrointestinal diseases (diseases affecting your digestive tract). But your digestive system also includes your mouth and esophagus, where you swallow your food. And it includes the organs in your biliary system, which supply bile and digestive enzymes to your intestines. These include your gallbladder, pancreas, liver and bile ducts. Gastroenterologists treat all of these organs.

Why would you go to a gastroenterologist?

Maybe you have symptoms related to your digestive system that your general physician hasn’t been able to diagnose or treat effectively. Or maybe you already know that you have a serious gastrointestinal condition and you want expert care for it. There are many benefits to seeing a specialist with extra training in the type of condition that’s affecting you. Gastroenterologists perform more gastrointestinal research, examinations and procedures than other doctors do. As a result, they are more likely to make accurate diagnoses, identify problems sooner and treat them with fewer complications.

What conditions do gastroenterologists diagnose and treat?

Common conditions that gastroenterologists treat include:

Gastrointestinal diseases (affecting your stomach and intestines), such as:

• Irritable bowel syndrome (IBS).
• Inflammatory bowel disease (IBD).
• Celiac disease.
• Small intestinal bacterial overgrowth (SIBO).
• Food allergies and intolerances.
• Stomach ulcers.
• Diverticulitis.
• Appendicitis.
• Colorectal polyps.
• Hemorrhoids.

Esophageal disorders, such as:

• Swallowing difficulties.
• Gastroesophageal reflux disease (GERD).
• Esophagitis.
• Hiatal hernias.

Liver diseases, such as:

• Viral hepatitis.
• Toxic hepatitis.
• Fatty liver disease.
• Cirrhosis.

Pancreatic, biliary and gallbladder diseases, such as:

• Gallstones.
• Cholecystitis.
• Pancreatitis.

What symptoms should I tell my gastroenterologist about?

You might come to a gastroenterologist with common gastrointestinal symptoms, such as:

• Abdominal pain.
• Bloated stomach.
• Indigestion.
• Gas and gas pain.
• Nausea and vomiting.
• Rectal bleeding.
• Diarrhea.
• Constipation or difficulty pooping.
• Unexplained weight loss or weight gain.
• Heartburn.
• Jaundice.

What does a gastroenterologist do?

A gastroenterologist may begin by physically examining you. They may feel and listen to your abdominal organs from the outside, or insert a finger into your rectum. They may order follow-up tests, such as blood tests, poop tests or imaging tests like GI X-ray exams that take pictures of your organs from the outside. But when they need more information than these tests can provide, gastroenterologists are specially trained to perform endoscopic procedures. These are exams that look inside your body with an endoscope — a tiny video camera on the end of a long, thin, flexible tube they insert into your body.

Endoscopic procedures include:

• Upper endoscopy or EGD: an examination of your upper GI tract, from your throat down through your stomach to your upper small intestine (duodenum).
• Enteroscopy: examination of your small intestine.
• Colonoscopy: an examination of your lower GI tract or large intestine.
• Endoscopic ultrasound: an upper or lower endoscopy with an ultrasound wand attached to the endoscope, which helps to visualize your biliary system.
• ERCP: endoscopic retrograde cholangiopancreatography, an upper endoscopy that extends into your bile ducts and then takes fluoroscopic X-rays of your biliary system (video X-rays).
• Polypectomy: removal of polyps from your stomach or intestines during endoscopy.

Endoscopy exams give gastroenterologists a more detailed view inside your body to see how things are working and what might be causing your symptoms. But that’s not all — gastroenterologists can also take tissue samples and perform minor interventions with tiny tools they pass through the endoscope. This makes endoscopy an intermediate step before surgery that gastroenterologists can take to treat your condition. And it’s often enough. Gastroenterologists can relieve blockages, open up narrowed channels, stop bleeding and remove tumors through the endoscope. They can also interpret the biopsy results.

Do gastroenterologists treat cancer?

A gastroenterologist is likely to be the first to discover if you have cancer in any of the organs of your digestive system. Through endoscopy and biopsy, gastroenterologists locate, remove and identify cancerous tumors throughout your GI tract and biliary system. If they do find cancer, they’ll likely conduct further endoscopic procedures to help stage it. That means they’ll take additional tissue samples to find out if the cancer has spread. In some cases, gastroenterologists can treat certain tumors through the endoscope, either by dissecting them or by targeting them with lasers.

Gastroenterologists may diagnose, stage or treat:

• Stomach cancer.
• Colorectal cancer.
• Gastrointestinal stromal tumors.
• Duodenal cancer.
• Small intestine cancer.
• Esophageal cancer.
• Liver cancer.
• Pancreatic cancer.
• Gallbladder cancer.
• Bile duct cancer.

But you might have a gastroenterologist on your care team for other types of cancer too. Your team might need a gastroenterologist to use their endoscopic skills to help look for signs of cancer spreading beyond the original site. Your team may also want to consult a gastroenterologist regarding the potential side effects of cancer treatment. For example, chemotherapy and radiation therapy can cause mucositis or radiation enteritis, painful inflammation in your GI tract. Symptoms such as nausea and vomiting, diarrhea, constipation and malnutrition are also common, and gastroenterologists can help.

What is the difference between a gastroenterologist and a proctologist?

Proctologists are surgeons who specialize in conditions affecting your large intestine. Your large intestine includes your colon, rectum and anus. The name, proctologist, refers specifically to the lower part of your large intestine — your rectum and anus. This may be one reason why it’s not used as much anymore. These days, you’re more likely to see a colorectal surgeon for conditions affecting your colon, rectum or anus that may require surgery. Colorectal surgeons tend to have a broader range of specialization than proctologists. They may treat conditions affecting your entire gastrointestinal tract.

The main difference between a colorectal surgeon or a proctologist vs. a gastroenterologist is that they train as surgeons. After medical school, they complete five years of surgical residency practicing general surgery before going on to receive special training in colorectal procedures. While they may treat you in other ways, such as conducting an examination or prescribing medication, they are specially prepared for operative procedures. A gastroenterologist may be able to tell you if you need surgery, but they wouldn’t be able to perform the operation. Instead, they’d likely refer you to a colorectal surgeon.

A note from Cleveland Clinic

Your digestive system is extensive, involving many different organs and processes. Together, they cooperate to break down the food you eat, absorb the nutrients you need and remove the waste that’s left over. This system is always working, so if some part of it isn’t working quite right, you’re bound to notice by the way you feel. Gastrointestinal symptoms are common, but understanding what’s causing them is not so easy. That’s where a specialist can help. By understanding how each organ works together, gastroenterologists can better understand what’s not working right in your digestive system.