Gastroenterology is an area of medicine that focuses on the health of the digestive system, or the gastrointestinal (GI) tract, as well as the liver. Gastroenterologists can treat everything from irritable bowel syndrome (IBS) to hepatitis C. Here’s a look at what these specialists do and when you should consider seeing one.
Gastroenterologists primarily diagnose and treat GI conditions. If your primary care physician has noticed an issue involving your GI tract, they will most likely recommend you see a gastroenterologist for a more detailed assessment of the issue.
Gastroenterologists perform endoscopic procedures, in which they use specialized instruments to view the GI tract and make a diagnosis.
They don’t perform surgery, though in some cases, they may work closely with a GI surgeon. They primarily work in clinic or hospital settings.
Health conditions gastroenterologists can diagnose and treat
Gastroenterologists are trained to have an acute knowledge of the normal movement of food through the stomach and intestine, the absorption of nutrients, how waste is removed from the body, and how the liver helps with the digestion process. This area of expertise allows them to diagnose issues such as:
- gastroesophageal reflux (heartburn)
- colon polyps
- gastroesophageal reflux disease (GERD)
- peptic ulcers
- gallbladder and biliary tract diseases
- nutritional issues
- irritable bowel syndrome (IBS)
Although the GI system includes the mouth, gastroenterologists generally don’t provide care or services for this area. Instead, dentists and dental specialists focus on the health of the oral cavity.
Gastroenterologists are also different from proctologists, who are specialists who treat diseases of the rectum and anus.
Gastroenterology is a specialized area of medicine that focuses on the GI tract. Some gastroenterologists treat general diseases of the GI. Others focus on a particular type of gastroenterology.
Some possible areas of emphasis are:
- pancreatic disease
- inflammatory bowel disease, or chronic inflammation of the digestive tract
- gastrointestinal cancer
- endoscopic surveillance
- reflux esophagitis, which is commonly due to GERD
Hepatologists, who focus on the diagnosis and treatment of diseases of the liver, gallbladder, biliary tree, and pancreas, aren’t always associated with gastroenterology, but every hepatologist must be certified in both internal medicine and gastroenterology.
The steps to becoming a gastroenterologist typically include:
- a 4-year college degree
- 4 years of medical school
- a 3-year training program, called a residency, in internal medicine, which includes work alongside experienced gastroenterologists and professional mentorship
After you complete your residency, you must complete a 2- or 3-year fellowship to receive more specialized training in this field. This includes training in endoscopy, which is a nonsurgical procedure doctors use to examine the GI tract.
Once you’ve completed your training, you must pass a specialty certification exam for gastroenterologists. The American Board of Internal Medicine certifies you upon successful completion of the exam.
Gastroenterologists perform a range of nonsurgical procedures. This can include:
- upper endoscopy, which helps diagnose conditions of the food pipe, stomach, and small intestine
- endoscopic ultrasounds, which examine the upper and lower GI tract, as well as other internal organs
- colonoscopies, which can detect colon cancer or colon polyps
- endoscopic retrograde cholangiopancreatography, which identifies stones or tumors in the bile duct area
- sigmoidoscopy, which evaluates blood loss or pain in the lower large bowel
- liver biopsy, which assesses inflammation and fibrosis in the liver
- capsule endoscopy and double balloon enteroscopy, which both examine the small intestine
- feeding tube insertion for inserting feeding tubes in the abdomen
Your primary care doctor may refer you to a gastroenterologist if you:
- have unexplained blood in your stool
- have unexplained difficulty swallowing
- are experiencing abdominal pain
- are experiencing digestion issues, such as constant constipation or diarrhea
- are experiencing constant acid reflux or heartburn
If you’re over the age of 50, you may also want to meet with a gastroenterologist for preventive care, as you may have an increased risk of colon cancer.
If you’re in this age group, you should get screened regularly. If you have a relative with colon cancer, you should ask your doctor about when to start getting screenings.
Gastroenterologists specialize in gastrointestinal issues, such as IBS, ulcers, polyps, and chronic heartburn. These doctors have 3 years of medical school under their belt, as well as 5 to 6 years of additional training. Typically, they don’t perform surgeries, but they do perform endoscopic procedures, which can help them diagnose and treat many GI conditions.
Your primary care physician will most likely recommend you visit a gastroenterologist if they notice something is off about your digestion, if you have pain in your stomach, or certain blood tests come back with elevated levels.