Who is a gastroenterologist?
Gastroenterologists are medical doctors specializing in preventing, diagnosing, and treating conditions affecting the organs of the digestive system. These organs include the stomach, esophagus, small intestine, gallbladder, pancreas, colon and rectum, liver, and bile ducts.
Gastroenterologists have a detailed understanding of the gastrointestinal organs' physiology (normal functions). These include:
- Movement or mobility of food through the esophagus, stomach, and intestine
- Digestion and absorption of food and nutrients
- Waste removal from the body
- The liver and its digestive functions
What kind of training do gastroenterologists receive?
A gastroenterologist must complete a three-year residency in internal medicine, after which they can pursue further specialized training in gastroenterology through a fellowship that typically lasts 2-3 years. By the end of this process, they will have accumulated 5-6 years of additional education beyond medical school.
The gastroenterology fellowship is a highly intensive program in which future specialists work closely with nationally recognized experts to gain a deep understanding of gastrointestinal diseases. During the training, they learn to evaluate and treat a wide range of digestive issues, provide preventive care, and manage conditions in both outpatient and hospital settings.
Some gastroenterologists receive further specialized training in advanced procedures like endoscopic retrograde cholangiopancreatography (ERCP), tumor removal without surgery (endoscopic mucosal resection or EMR), placing internal stents, and endoscopic ultrasound (EUS). These skills allow them to perform non-surgical procedures to treat bile duct stones, evaluate and manage gastrointestinal and liver tumors, and offer minimally invasive alternatives to surgery.
This training emphasizes attention to detail and thorough knowledge of the gastrointestinal system to ensure the highest quality of care. National organizations like the American Board of Internal Medicine and the American Society for Gastrointestinal Endoscopy supervise the fellowship training to ensure uniform, high-quality education. After completing their fellowship, trainees become board-eligible and can take the gastroenterology board certification exam. Passing this exam qualifies them as a board-certified healthcare professional.
The letters FACG and FACP, which may appear after a gastroenterologist's name, signify special recognition from professional organizations like the American College of Gastroenterology and the American College of Physicians. Physicians who have demonstrated exceptional achievements in research, teaching, or service in gastroenterology and have met the rigorous criteria set by these organizations receive these honors.
Common gastrointestinal conditions
Gastroenterologists treat conditions of all the organs in your digestive system, including the gastrointestinal tract (esophagus, stomach, and intestine) and organs transporting digestive juices (liver, bile duct, pancreas, and gallbladder). Below are some common diseases that gastroenterologists treat, categorized based on the organs affected.
Conditions affecting the esophagus (food pipe):
- Esophagitis
- Hiatal hernias
- Gastroesophageal reflux disease
- Swallowing difficulties
Digestive conditions of the stomach and intestines (gastrointestinal):
- Inflammatory bowel disease
- Stomach ulcers
- Appendicitis
- Hemorrhoids
- Irritable bowel syndrome
- Food intolerances and allergies
- Small intestinal bacterial overgrowth
- Celiac disease
- Colorectal polyps
The liver is an important organ involved in the digestion of food and detoxification of the blood. The following conditions can affect normal liver functions:
- Cirrhosis
- Toxic hepatitis
- Viral hepatitis
- Fatty liver disease
The pancreas produces insulin and hormones that maintain the blood-sugar levels in your body. The gallbladder and bile duct secrete bile juices to digest fats and carry out digestive waste. Some of the most prevalent conditions affecting these organs are:
Diagnostic procedures commonly used by gastroenterologists
Gastroenterologists can perform several procedures to diagnose and treat the conditions.Â
Endoscopy: To perform an endoscopy, a gastroenterologist would attach a camera to a long, thin tube (endoscope) to look inside the digestive tract. The endoscope, inserted through the mouth, sends back images on the screen for the doctor to monitor and diagnose the condition.
A doctor will recommend endoscopy if the patient is experiencing stomach pain, ulcers, gastritis, difficulty swallowing, bleeding in the digestive tract, and changes in bowel habits. The doctor also checks for any growth or polyps in the colon. There are a few ways to prepare for the endoscopy:
- Ensure to stop eating anything 6-8 hours before the endoscopy
- A laxative is given to the patient to clear the colon of stool
- Sedatives are given just before the procedure to relax the patient
Colonoscopy: Colonoscopy is performed mainly to monitor the colon. It is similar to endoscopy, where the doctor inserts a tube, and the images are visible on the screen. The difference, however, is the tube, in this case, is inserted through the rectum rather than the mouth.
People suffering from early signs of colon or rectum cancer, causes of bowel habit changes, and symptoms like abdominal pain or rectal bleeding would require a colonoscopy. The patient might feel cramps during the procedure, which usually disappear once done. If the doctor finds something abnormal, they can take small tissue samples for biopsy. Colonoscopies are accurate and successfully diagnose and treat the conditions without the patient undergoing any major operation.
Before the procedure, inform the doctor about any other condition you might be suffering from. Apart from this, there might be some diet and fluid restrictions before having a colonoscopy, which the doctor will direct. The doctor can also administer laxatives to ensure the colon is clear.Â
After the procedure, the patient must stay for 30 minutes in the recovery room for observation. There might be cramping or passing gas sensations, which will go away quickly. Once the procedure is over, the patient can return to a regular diet. Although very rare, if there are severe issues like excessive rectal bleeding, severe abdominal pain, fever, or chills, one must contact their doctor as soon as possible.
Polypectomy: This is a procedure to remove polyps from the bowel. Polyps are non-cancerous growths on the colon lining. The two most common forms of polypectomies are uterine polypectomy and colon polypectomy.
Doctors, after the screening, diagnose the presence of polyps. However, polyps only require removal if they start causing pain and bleeding symptoms. Some of the risks associated with the procedure are:
- Organ perforation- The colonoscope might end up puncturing the organ it operates on, which can cause fatal injury and is very rare.
- Infection- A polypectomy can cause a wound to become infected, mainly if the patient doesn't follow the doctor's restrictions.
- Excessive bleeding- If the wound doesn't heal, it might cause bleeding.
- Incomplete removal- Some tissues might be left while performing the procedure, requiring repeated removal.
When should you see a gastroenterologist?
The top reasons why you should consider seeing a gastroenterologist near you include the following:
- Severe or sudden abdominal pain- Sudden and severe abdominal pain may indicate an underlying condition, such as peptic or stomach ulcer. If untreated, stomach ulcers can cause scarring and swelling. Continuous severe abdominal pain can also indicate liver disease, pancreatitis, or gallstones. Gastroenterologists can diagnose and treat the condition, preventing it from becoming a significant complication.
- Unusual bloating- Bloating is when the belly feels tight or full. It may happen due to excess gas production, gas trapped in the colon, or hypersensitivity to gas. Lactose intolerance, irritable bowel syndrome, and small intestinal bacterial overgrowth can cause bloating. Gastroenterologists can detect the exact cause of bloating and provide appropriate treatment.
- Constipation- When the bowel movement frequency is less than three times a week, it is considered constipation. People may feel constipated if the bowel movements are uncomfortable or infrequent. Gastroenterologists can recommend appropriate medications and lifestyle changes to regulate bowel movements.Â
- Diarrhea- Certain medications, infections, and foods can cause diarrhea. Chronic diarrhea can also indicate digestive disorders such as small bacterial overgrowth, irritable bowel syndrome, or inflammatory bowel disease. Gastroenterologists help diagnose and treat the condition and manage the symptoms.Â
- Severe heartburn- If you have severe heartburn more than two times a week, it is a sign of GERD or Gastroesophageal reflux disease. If untreated, the reflux can cause permanent damage to the inner wall of the esophagus. It may cause painful ulcers and increase the risk of esophageal cancer. See the gastroenterologist at the earliest if you have severe heartburn symptoms.Â
What are the causes of constipation?
Symptoms of constipation include hard, dry stools, and its common causes include:
- Medications
- Lack of exercise
- Inadequate liquid intake
- Insufficient dietary fiber
- Irritable bowel syndrome
- Changes in habits or lifestyle (e.g., travel, pregnancy, old age).
- Problems with intestinal function.
Additionally, the abuse of laxatives can contribute to constipation. When the colon's muscle contractions are insufficient, the stool moves too slowly, leading to excessive water absorption and solidifying the stool.
Constipation manifests through symptoms such as difficult and painful bowel movements, fewer than three weekly bowel movements, bloating, discomfort, and abdominal pain. Diagnosis involves considering the duration, severity, age, blood in stool, changes in bowel habits, or weight loss. A medical history review covers symptom details and frequency, while a physical examination, including a digital rectal examination (DRE), assesses muscle tone and detects abnormalities.Â
How does a gastroenterologist diagnose constipation?
When you visit a gastroenterologist near you, the diagnostic tests they employ may include:
- Abdominal X-rays.
- A lower GI series using barium enema.
- Colonoscopy to view the large intestine.
- Sigmoidoscopy for examining a portion of the large intestine.
- Colorectal transit study tracking food movement through the colon.
Anorectal function tests diagnose constipation from the anus or rectum dysfunction. Constipation causes complications such as hemorrhoids and anal fissures because of straining during bowel movements, resulting in rectal bleeding. Straining may also cause rectal prolapse, where a portion of the intestinal lining protrudes from the anal opening. Fecal impaction, more common in children and older adults, occurs when hard stool packs the intestine tightly, impeding normal expulsion.
What kind of treatments do gastroenterologists recommend for constipation?
Your doctor tailors constipation treatment based on your age, health, and medical history. Dietary changes, including 20 to 35 grams of daily fiber through beans, whole grains, fruits, and vegetables, help form soft and bulky stools. Limiting low-fiber foods like ice cream and processed items is advised.Â
If diet adjustments aren't effective, the doctor may prescribe laxatives. Other options include medication changes and biofeedback, which retrains muscles for bowel control. Lifestyle changes, like increased fluid intake and exercise, aid treatment. Your doctor will assess the extent and specifics of the condition to formulate an effective plan aligned with your preferences.
How do you keep your gut healthy?
Our digestive tract has an abundant amount of microorganisms that are beneficial for our health. Maintaining gut health means maintaining a balance of those microorganisms, as any irregular change can affect our mental and physical health. Here are some ways to care for gut health and enhance our overall health:
- Taking probiotics and consuming fermented foods can boost the beneficial bacteria. Some examples are fermented vegetables, kimchi, and kombucha.
- Research suggests that prebiotics help probiotics become more tolerant to adverse conditions like pH and temperature changes. Foods rich in prebiotics include asparagus, bananas, garlic, and whole grains.
- Restricting sugar and sweeteners, as too much sugar can affect the microbes and cause imbalance, can further increase the number of certain microbes strains linked with metabolic diseases such as diabetes and heart diseases.
- Reducing stress can help improve a person's overall health, including gut health. Stressors can include psychological stress, environmental stress, sleep deprivation, and disruption of the circadian rhythm. Meditating, regularly exercising, maintaining a healthy diet, and sleeping well can help reduce stress.
- Avoiding too many antibiotics, in addition to combating bacterial infections in the body, can also kill the good bacteria in the gut. Overusing antibiotics can result in antibiotic resistance.
- Avoiding smoking can help restore the imbalance in microbes caused by smoking. Smoking decreases the levels of beneficial bacteria in the intestine and increases the number of potentially harmful microorganisms.Â
Top-rated gastroenterologists in San Antonio, TX
Gastrointestinal problems require immediate attention and decrease the quality of life to a great extent. It is essential to check the symptoms on time to avoid any significant issues in the future. However, booking appointments with your choice of gastroenterologist can be tricky. Long queues outside their practices and long waiting hours can be very difficult. Zocdoc can help you instantly book appointments with gastroenterologists in your city.Â
Zocdoc aims to bridge the gap between patients and providers throughout the United States. Using the area-based search on Zocdoc, you can find a list of top specialists near you in minutes!
Zocdoc lists top-rated doctor profiles with detailed information about their experience, expertise, qualifications, ratings, and languages. You can also enter your insurance plan/carrier in the search bar to get a list of providers that accept your insurance.Â
If you need help finding gastroenterologists who accept your insurance, our online patient help center can help. With Zocdoc, you can link your medical, dental, and vision insurance plans to your account, though you can use only one insurance plan per appointment. You can add your secondary insurance details in the appointment notes for those with multiple insurance plans. If your healthcare provider uses Zocdoc's Intake forms, you also have the option to input your secondary insurance information there.
With our easy-to-use platform, you can instantly book video or in-person appointments from the comfort of your home.
Booking appointments with a gastroenterologist near you on Zocdoc is simple, secure, and free!
Statistics on gastrointestinal disorders in San Antonio
According to the data published on the American Cancer Society website, colorectal cancer is the third most common type of cancer diagnosed in the United States. It also states that there were approximately 106,180 cases of colon cancer and about 44,850 cases recorded in the country in 2022.Â
According to the Communicable Disease Report, Bexar County 2017, by Metropolitan Health District, City of San Antonio, the incidence of acute Hepatitis A, B, and C cases was reported as 0.9%, 0.6%, and 0.2%, respectively, per 100,000 people.
Sources
Medical New Today
WebMD
American Cancer Society
City of San Antonio
American College of Gastroenterology
Cleveland Clinic
Houston Methodist
Johns Hopkins Medicine
