What does a gastroenterologist do?
A gastroenterologist’s specialty is diagnosing and treating gastrointestinal (GI) diseases, that is, ailments affecting the digestive system. The human digestive system comprises the stomach, esophagus, gallbladder, pancreas, intestines, and rectum. Hepatitis, colorectal or liver cancer, colon polyps, irritable bowel syndrome (IBS), peptic ulcers, colitis, and gallbladder and biliary tract diseases are some reasons you might need a gastroenterologist. Pancreatitis, gastroesophageal reflux, and nutritional deficiencies are other conditions they address.
While gastroenterologists receive training in diagnostic procedures such as colonoscopy and endoscopy, they are not certified to perform surgeries. They use various diagnostic tools and techniques, including barium swallow, X-rays, CT scans, and blood and stool tests, to discover the disease's cause and related symptoms.
Education and training
An aspiring gastroenterologist must complete six years of specialized training and education after medical school. This is known as fellowship training, and during this period, they undergo extensive training in everything related to gastroenterology. The American College of Gastroenterology, the American Board of Internal Medicine, and the American Society for Gastrointestinal Endoscopy oversee this specialization training. After the training, practitioners can choose to be board-certified.
Gastrointestinal diseases
Gastrointestinal diseases impact the entire GI tract, spanning from the mouth to the anus. These diseases fall into two categories: functional and structural.
Functional GI diseases generally cause the GI tract to appear normal during examination but impaired movement. They represent the most prevalent GI tract issues, including the colon and rectum. Common examples include constipation, nausea, gas, bloating, and diarrhea.
Structural GI diseases can cause the GI tract to appear abnormal upon examination and impair bowel functionality. In some cases, surgical removal may be necessary to address the structural abnormalities. Examples of common structural GI diseases include strictures, stenosis, hemorrhoids, diverticular disease, colon polyps, colon cancer, and inflammatory bowel disease.
Common gastrointestinal disorders:
- Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS), also known as spastic colon, irritable colon, or nervous stomach, is a functional condition characterized by irregular contractions of intestinal muscles, occurring more or less frequently than typical. Triggers for IBS can include specific foods, medications, and emotional stress.
Hemorrhoids refer to enlarged veins in the anal canal, constituting a structural ailment. These are induced by prolonged and excessive pressure, typically stemming from straining during bowel movements, persistent diarrhea, or pregnancy. Hemorrhoids are of two types:
Internal hemorrhoids are blood vessels situated inside the anal opening. When these vessels descend into the anus due to straining, irritation and bleeding may occur. In advanced cases, internal hemorrhoids may prolapse, extending or protruding from the anus.
External hemorrhoids are veins located just beneath the skin on the exterior of the anus. Occasionally, following straining, these superficial hemorrhoidal veins may rupture, forming blood clots beneath the skin. Piles is another name for this intensely painful condition.
Anal fissures are another form of structural disease characterized by splits or cracks in the lining of the anus. The primary cause of an anal fissure often stems from the passage of excessively hard or watery stools. The fissure exposes the underlying muscles responsible for regulating the passage of stool through the anus and out of the body. Anal fissures are notably painful as the exposed muscles become irritated from contact with stool or air, resulting in intense burning pain, bleeding, or spasms following bowel movements.
Perianal abscesses, categorized as a structural ailment, may arise when the small anal glands that open on the inner side of the anus become obstructed, leading to an infection caused by the bacteria inherently present in these glands—the accumulation of pus leads to the development of an abscess.
Most colorectal cancers begin as colon polyps—non-cancerous growths in the tissues that line the colon and rectum. The onset of cancer occurs as these polyps grow, giving rise to abnormal cells that invade the surrounding tissue. Eliminating polyps is a preventative measure to impede the advancement of colorectal cancer.
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Gastroenterologists can painlessly eliminate most precancerous polyps through colonoscopy screening. If undetected in its early stages, colorectal cancer can metastasize throughout the body, necessitating more intricate surgical interventions in advanced cases.
The absence of symptoms in the initial phases of colorectal cancer underscores the critical importance of screening. Symptoms, when they do manifest, may indicate an already advanced stage of cancer. These symptoms include blood in or with the stool, alterations in regular bowel habits, stool narrowing, abdominal pain, weight loss, or persistent fatigue.
Six reasons to schedule a gastroenterologist appointment
Symptoms of gastrointestinal diseases can be hard to spot, leading to further disease progression. See a gastroenterologist near you at the earliest if you have any of these symptoms:
1) Recurrent heartburn – If you experience heartburn regularly, more than twice a week, it is cause for concern. Frequent heartburn is one of the symptoms of acid reflux or gastroesophageal reflux disease (GERD). It needs to be diagnosed by a gastroenterologist.
2) Chronic diarrhea - Most cases of diarrhea resolve in 24 to 48 hours. If diarrhea persists or your fever exceeds 102°F, you may need to see a specialist to find the cause. Malabsorption syndromes, irritable bowel syndrome, ulcerative colitis, Crohn's disease, and colon cancer are a few causes of chronic diarrhea.
3) Weight loss – Unexplained weight loss is concerning, especially when you have not changed your diet or lifestyle. This could indicate a gastrointestinal problem. Celiac disease and cancer can cause unexplained weight loss.
4) Bloody stools – Blood loss from stools can go unnoticed, eventually leading to iron deficiency and anemia. One of the common causes of bloody stools is hemorrhoids. While home remedies and over-the-counter (OTC) treatments may resolve this problem, you should see a specialist if it does not. Your doctor will test to determine if something other than hemorrhoids is causing the bleeding.
5) Difficulty swallowing - If swallowing is painful or difficult, consult a gastroenterologist immediately. They may perform an upper endoscopy to determine the cause.
6) Severe bloating - While bloating that lasts a few hours or even a day is quite normal, it is unusual to feel bloated constantly. Causes of more severe bloating include small intestinal bacterial overgrowth (SIBO), IBS, and lactose intolerance. A gastroenterologist can determine the reason for chronic bloating and help improve your quality of life.
Standard diagnostic tests for GI diseases
Gastroenterologists have different means of arriving at a diagnosis. They will first inquire about your medical history and any symptoms you may be experiencing. The specialist will conduct a general physical exam to check your vitals before suggesting further tests. If your gastroenterologist suspects an infection, they will recommend a fecal test. You will have to provide samples of your stool to the lab.
If the doctor has prescribed a breath test for you, the lab will check your breath using specific equipment. This test helps detect stomach bacteria overgrowth and issues such as lactose intolerance. To visualize the digestive system internally, your doctor may conduct an endoscopy, colonoscopy, or sigmoidoscopy. These tests can help them identify intestinal, colonic, gastric, esophageal, and duodenal disorders.
Other tests, such as endoscopic retrograde cholangiopancreatography (ERCP), are used to explore better the liver, pancreas, gallbladder, and bile ducts. Gastroenterologists also use barium enema, gastric manometry, and barium beefsteak meal tests for diagnostic purposes.
What is an enema and upper endoscopy?
A barium swallow or enema involves using barium, a liquid that enhances the visibility of certain areas inside your body on a scan. The doctor will ask you to drink the barium to examine the esophagus, stomach, or upper small intestine. Alternatively, you may require a barium enema if the doctor needs to check your colon or rectum. They will then take X-rays, allowing the doctor to observe the movement of your organs in real time.
An upper endoscopy involves a long, thin tube with a tiny camera on the end that is inserted through your mouth. This allows the doctor to examine your upper digestive tract or take a biopsy (tissue sample). The gastroenterologist may recommend this procedure if you experience ongoing issues like persistent heartburn, abdominal pain, vomiting, or other symptoms that don’t resolve independently.
What is a colonoscopy, and when might a doctor recommend it?
A colonoscopy involves the doctor inserting a thin, camera-equipped scope through the rectum to examine the colon, rectum, or large intestine. It allows the gastroenterologist to check for polyps or bleeding, remove any polyps, or take a tissue sample (biopsy). The gastroenterologist may recommend a colonoscopy to investigate issues like blood in the stool, inflammatory bowel disease, abdominal pain, or changes in bowel habits.
What is an enteroscopy, and why would a doctor order this procedure?
If a standard endoscopy or colonoscopy doesn't identify the cause of symptoms, the gastroenterologist may order an enteroscopy. In this procedure, you swallow a tiny video capsule that captures images of your digestive tract as it passes through. This test can help detect sources of bleeding, ulcers, or other issues related to Crohn’s disease.
How to avoid gastrointestinal issues at home?
Digestive issues are prevalent. They usually include bothersome gas, heartburn, constipation, and more. But, it is possible to prevent these with some simple tips. Below are some expert-suggested methods to avoid and treat these common gastrointestinal issues:
Gas is typical in a healthy digestive system. However, some foods, drinks, and medications cause more gas than usual. Moreover, bloating, or swelling in your abdomen and a sense of fullness, can occur when gas builds up in your stomach and intestines.
Changes in diet and lifestyle can certainly help in both cases. Reducing fatty foods, avoiding fizzy drinks, eating and drinking slowly, and exercising are baby steps. It is also wiser to stop chewing gum, limit sweeteners, and avoid smoking. Examples are fructose and sorbitol (found in candies, energy bars, and low-carb foods).
Over-the-counter medicine such as lactase supplements, alpha-galactosidase, simethicone, and probiotics might also help. However, consider your doctor's or pharmacist's advice before taking any of these.
Heartburn, or acid indigestion, is a burning, uncomfortable sensation in the upper portion of your stomach or center of your chest. The pain, which can also affect your neck, jaw, and arms, might last for a while or linger for several hours.
Overeating, consuming spicy, fatty, acidic, greasy foods, caffeine or alcohol, smoking, lying down shortly after eating, or excessive stress can sometimes cause heartburn. Also, people who are overweight, pregnant, or have a hiatal hernia are more likely to experience it.
Try eating meals in small chunks throughout the day rather than three large meals daily. Losing weight if you are overweight, wearing loose clothing, avoiding smoking, and limiting high-impact exercise are some ways to prevent heartburn.
You can feel constipated for many reasons, including:
- Not drinking enough water
- Eating a diet low in fiber
- Traveling or changing your routine
- Getting too little exercise
- Taking certain medicines
- Medical issues like cancer, diabetes, IBS, and hypothyroidism
- Blockages in the large intestine
- Pregnancy
- Taking too many laxatives
- Nerve problems or muscles around the large intestine or rectum
Drinking enough water (60-80 ounces per day), having 20-35 grams of fiber per day, and eating more vegetables and fruits can solve the problem at initial levels. Drinking herbal tea or warm water in the morning and regularly exercising are other solutions.
Moreover, consult a physician if you are constipated for over two weeks or have extreme pain or other symptoms.
Find experienced gastroenterologists near you in Murrieta
Frequent digestive problems can prove painful and disruptive. Approach a gastroenterologist for an accurate diagnosis and treatment. Ideally, you should consult a board-certified specialist, as these practitioners undergo all the necessary training over a stipulated period before clearing the board exam. If you need assistance finding the right specialist, Zocdoc is here to help.
We use an advanced algorithm to give you access to our extensive database of specialists nationwide. Enjoy the convenience of choosing an experienced gastroenterologist in your vicinity in Murrieta from the comfort of your home. You can create a free account on the Zocdoc platform and use our location, gender, and experience filters to narrow your search. Select the practitioner's profile to learn more about their educational qualifications, experience, board certifications, and spoken languages. You can also check for insurance networks and see verified patient reviews and ratings to know each specialist better.
If you need help finding gastroenterologists who accept your insurance, our online patient help center is here to help. On Zocdoc, you can connect your medical, dental, and vision insurance plans to your account, though you can use only one insurance plan per appointment.
For those with multiple insurance plans, you can add your secondary insurance details in the appointment notes. You can also enter your secondary insurance information if your healthcare provider uses Zocdoc's Intake forms.
You can also find doctors available beyond regular business hours and on weekends. Schedule an appointment once you zero in on the right gastroenterologist for your needs. You could request a virtual appointment before an in-person consultation with the practitioner. With Zocdoc, locating the best gastroenterologists near you is now easier.
Booking appointments with Zocdoc is free, simple, and secure!
Statistics on Gastroenterological Diseases in California
According to the National Health Interview Survey of 2018 published on the Centers for Disease Control and Prevention (CDC) website, around 14.8 million adults, or 5.9%, have been diagnosed with ulcers. The same survey indicates that about 4.5 million, or 1.8%, of adults, are diagnosed with chronic liver disease and cirrhosis. The national mortality rate associated with liver disease is 15.7 per 100,000.
According to state-wise data compiled by the National Center for Health Statistics on the website of the Centers for Disease Control and Prevention (CDC), the mortality rate for chronic liver disease in California in 2022 was 14.9 per 100,000. However, chronic liver disease and cirrhosis are among the state's ten leading causes of death.
Similarly, the Colorectal Cancer Facts & Figures 2020-2022 report by the American Cancer Society shows that in January 2019, around 776,120 men and 768,650 women lived with colorectal cancer in the United States. These figures help us understand our society's gastrointestinal diseases and cancer burden.
Sources
WebMD[1]
WebMD[2]
WebMD[3]
American College of Gastroenterology
Physicians Alliance of Connecticut
Johns Hopkins Medicine
Centers for Disease Control and Prevention[1]
Centers for Disease Control and Prevention[2]
American Cancer Society
Cleveland Clinic
