Who are gastroenterologists?
Gastroenterologists are medical doctors with specialized training in internal medicine who focus on preventing, diagnosing, and treating disorders affecting the digestive system. The various parts of the digestive tract include the esophagus, stomach, gallbladder, pancreas, liver, small intestine, large intestine (colon), and rectum. You should visit a gastroenterologist near you if you have any issues or problems with the above.
Educational qualifications to become a gastroenterologistÂ
Becoming a gastroenterologist involves a substantial amount of education and training. The first step is to earn a bachelor's degree, which usually takes around four years to complete.
The next step is to gain admission into a medical school. Medical school typically requires four years to complete classroom and clinical education. During the initial years of medical school, students take courses in medical sciences, such as anatomy, physiology, and pharmacology. During the final two years, students work with patients under the supervision of licensed physicians.
Aspiring gastroenterologists must complete a residency program. A residency typically lasts three years and involves learning to diagnose, treat, and manage diseases and disorders affecting internal organs. Gastroenterologists must then complete a fellowship program in gastroenterology, which lasts for two to three years.Â
Finally, after completing all necessary education, gastroenterologists must clear the certification examination conducted by the American Board of Internal Medicine. This exam aims to test the knowledge and skills essential to practice gastroenterology at a high level of competence. Once certified, gastroenterologists can obtain licensure to practice and begin their careers as healthcare providers.
What is the difference between gastroenterologists and proctologists?
Proctologists, now more commonly referred to as colorectal surgeons, are surgeons who focus on conditions affecting the large intestine; this includes the colon, rectum, and anus. Colorectal surgeons specialize in treating conditions across the entire gastrointestinal (GI) tract, not just the large intestine's lower part.
The critical difference between colorectal surgeons (or proctologists) and gastroenterologists is their training. Colorectal surgeons can perform surgery. After medical school, they complete a five-year surgical residency in general surgery before specializing in colorectal procedures. While they can also conduct examinations or prescribe medications, their primary expertise is performing surgeries. A gastroenterologist would refer you to a colorectal surgeon if surgery is needed.
Common conditions treated by gastroenterologists
Gastroenterologists have a thorough knowledge of the normal functioning of the digestive system and all the diseases that affect these areas. They regularly diagnose and treat the following illnesses: colon polyps and colon cancer, cirrhosis, Crohn's disease, hepatitis, pancreatitis, gallbladder disease, peptic ulcers, ulcerative colitis, liver cancer, Gastroesophageal Reflux Disease (GERD), and Irritable Bowel Syndrome (IBS).
What are colon polyps?
The colon or large intestine has an inner lining. Any growths formed on the lining of the colon or rectum are called colon polyps. The colon may include many polyps ranging from a few millimeters to several centimeters. The appearance of polyps might be flat or elevated. When grown, they can appear as small bumps (known as sessile) or even grow on short stalks (known as pedunculated), looking like a small mushroom or cauliflower.
Frequently asked questions about colon polyps:
1. How do colon polyps develop?
Cells in our body grow and divide in a certain rhythm and frequency. The uncontrollable growth of cells in the colon leads to the formation of colon polyps.
2. Am I at risk of developing colon polyps?
Several factors contribute to increasing your chances of developing colon polyps. Some of the important ones include the following-
- if you are 45 years or older
- have habits like smoking and drinking
- if you are obese, consume fatty foods daily, and don't exercise regularly
- if you have a past or family history of colorectal cancer or colon polyps
- if you have inflammatory intestinal conditions like Crohn's disease/ulcerative colitis
- if you have any of the following hereditary polyp disorders; Lynch syndrome, Peutz-Jeghers syndrome, Familial Adenomatous Polyposis (FAP), Gardner's syndrome (a variant of FAP), and serrated polyposis syndrome.
3. Why are colon polyps dangerous?
Not all colon polyps cause harm when detected and removed on time. However, some can develop into colorectal cancer over time and be fatal.
4. Do all colon polyps turn into colorectal cancer?
There are two kinds of colon polyps: non-neoplastic and neoplastic. Only the neoplastic variety, including adenomas and serrated polyps, is deadly and can develop into colorectal cancer. Non-neoplastic types, including inflammatory polyps, hyperplastic polyps, and hamartomatous polyps, do not typically become cancerous.
5. How would I know if I have colon polyps?
Colon polyps usually don't present with symptoms and are detected in routine examinations. Sometimes, however, they give as a change in the color of the stools, which can be black or have red streaks, any change in bowel movements that last longer than a week, abdominal pain with severe cramps, bleeding from the rectum, unexplained weight loss or incidence of iron deficiency anemia, and development of sudden fatigue or shortness of breath.
6. What is colon polyp screening?
Screening for colon polyps is testing for the condition before the symptoms appear. Since colon polyps carry the chance of developing into colon cancer, which is the third leading cause of death in the US, it is crucial to undergo timely screening tests.
Without any risk factors for developing colorectal cancer, gastroenterologists recommend screening begin from 45 years of age. If you carry any risk factors, the screening starts young. Doctors recommend performing it more frequently.Â
7. What tests do doctors perform to check for colon polyps?
Some standard screening tests used for screening and diagnosing colon polyps include:
- Colonoscopy - In this test, gastroenterologists pass a thin, flexible, long tube with a light and camera through the rectum into the large intestine to check for polyps in the intestinal and rectal lining.
- Virtual colonoscopy/CT colonoscopy - In this test, X-rays and computers are used to track any polyps in the colon or rectum.
- Flexible sigmoidoscopy - involves passing a flexible tube through the rectum into the colon.
- Barium enema/lower intestinal series - In this test, the gastroenterologist fills the large intestine with a liquid containing barium and then takes X-rays to detect colon polyps.
- Laboratory stool tests - such as the fecal occult blood test (FOBT) and the fecal immunochemical test (FIT)- detect traces of blood in the stools and gene changes suggesting colon polyps.
8. What should I do before a colonoscopy?
It is crucial to clear out the colon's contents before a colonoscopy. If the colon is not empty, the gastroenterologist cannot view the colon wall and will advise a follow-up colonoscopy. In preparation for colonoscopy, gastroenterologists will ask you to shift to a complete liquid diet one day before the test and take a prescription laxative in pill or liquid form the night before.Â
They may also ask you to adjust the medication dosage or completely stop it before the test. Bowel movements in a fully prepared colon appear clear, slightly yellow, or green.
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9. What will happen if my gastroenterologist finds colon polyps?
If the screening tests detect polyps in the colon or rectum, gastroenterologists will remove them and send them for microscopic analysis. Depending on the type of polyp, the number of polyps detected, the size of individual polyps, and the presence of other risk factors for developing polyps and cancer, they will ask you to undergo a repeat screening test.
10. What are some healthy habits to reduce the chances of developing colon polyps?
Reducing the risk of developing colon polyps is possible by following simple lifestyle changes such as:
- Choosing healthy habits such as eating a balanced diet, including a regular exercise regime in your daily life, quitting tobacco usage, and limiting alcohol consumption.
- Some clinical studies show that calcium and vitamin D supplements help prevent colon polyps' recurrence. However, talk to a gastroenterologist before starting on these supplements.
- A low dose of aspirin minimizes the risk of colon polyps and cancer. Before beginning the treatment, discuss the pros and cons of including daily aspirin with your gastroenterologist.
- If you have a past or family history of colon polyps, talk to your gastroenterologist about genetic counseling and recommended screening for polyps.
What are the causes of constipation?
The primary cause of constipation is the absorption of too much water in the colon, leading to the formation of hard, dry stools. The colon, also known as the large intestine, normally absorbs water as food moves through it, forming a stool. Muscle contractions then propel the stool toward the rectum, and by the time it reaches the rectum, most of the water is absorbed, resulting in solid stools.
Several factors can contribute to constipation, some of which are listed below:
1. Overuse or abuse of laxatives can disrupt the natural bowel movement processÂ
2. A low-fiber dietÂ
3. Side effects of medications
4. Lack of exercise
5. Irritable Bowel Syndrome (IBS)
6. Inadequate fluid intakeÂ
7. Factors such as travel, pregnancy, and old age can lead to changes in habits or lifestyle that contribute to constipation
8. Ignoring the natural urge to have a bowel movementÂ
9. Issues with the normal functioning of the intestinesÂ
Understanding these causes is important to develop effective strategies to prevent or alleviate constipation and promote regular and comfortable bowel movements.
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How does a gastroenterologist treat constipation?
Initial treatment approaches by gastroenterologists often involve dietary/lifestyle changes to promote healthy bowel movements. These changes may include adopting a high-fiber diet, increasing water intake, regular exercise, and maintaining good bowel habits. They may recommend over-the-counter laxatives, fiber supplements, osmotics, stimulants, lubricants, or stool softeners if the former measures prove insufficient. They may recommend enemas or suppositories in more severe cases.
If other treatments are ineffective, the doctors may prescribe medications like lubiprostone, linaclotide, plecanatide, prucalopride, or those designed to counteract the effects of opioids on stool movement. For specific cases, they may advise pelvic muscle training through biofeedback, involving working with a therapist to learn to relax and coordinate pelvic muscles.
When other treatments fail, a gastroenterologist may suggest surgery to address damage or irregularities in the colon or rectum tissues or nerves. It is important for individuals experiencing constipation to consult a GI specialist near them, who can tailor an appropriate diagnostic and treatment plan based on their specific circumstances.
Which non-surgical procedures does a gastroenterologist perform?
A gastroenterologist can perform a range of non-surgical procedures, including:
- Upper endoscopy helps diagnose food pipe, stomach, and small intestine conditions.
- Endoscopic ultrasounds check the upper and lower GI tract and other internal organs.
- Endoscopic retrograde cholangiopancreatography (ERCP): It helps identify stones or tumors in the bile duct area.
- Sigmoidoscopy: This evaluates blood loss or pain in the lower large bowel.
- Liver biopsy: This helps to assess inflammation and fibrosis in the liver.
- Capsule endoscopy and double balloon enteroscopy help examine the small intestine.
- Feeding tube insertion: This procedure involves inserting feeding tubes in the abdomen to provide nutrition.
Does a gastroenterologist treat cancer?
A gastroenterologist is often the first to detect cancer in any digestive system's organs. Through procedures like endoscopy and biopsy, they can locate and remove cancerous tumors throughout the gastrointestinal (GI) tract and biliary system. If they diagnose cancer, the gastroenterologist may perform additional endoscopic procedures to determine its stage by collecting more tissue samples to assess if the cancer has spread. In some instances, they can also treat specific tumors endoscopically by dissecting them or laser treatment.
Gastroenterologists may diagnose, stage, or treat cancers such as:
- Stomach cancer
- Colorectal cancer
- Gastrointestinal stromal tumors
- Duodenal cancer
- Small intestine cancer
- Esophageal cancer
- Liver cancer
- Pancreatic cancer
- Gallbladder cancer
- Bile duct cancer
Additionally, gastroenterologists can be part of your care team for other types of cancer. They may assist using their endoscopic expertise to check if cancer has spread beyond its original site. They may also provide support in managing mucositis or radiation enteritis, some common side effects of chemotherapy and radiation. Gastroenterologists can also help manage symptoms like nausea, vomiting, diarrhea, constipation, and malnutrition that may arise during treatment.
When should one visit a gastroenterologist?
Suppose you're experiencing digestive issues like constant constipation or diarrhea, abdominal pain, unexplained blood in your stool, or unexplained difficulty swallowing. In that case, your primary care doctor may refer you to a gastroenterologist. You may also need to visit a gastroenterologist if you're experiencing constant acid reflux or heartburn. Preventive care may be necessary for those over 50 due to an increased risk of colon cancer. Regular screenings are also essential in this case.
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Find the best gastroenterologists near you in San Diego, CA
Around 30% of adults in the US over 45 have colon polyps, which may or may not progress to colorectal cancer. It is important to undergo regular screening to catch the polyps at their inception. Finding the right GI specialist near you who is easy on your pockets or accepts your insurance policy can be very tiresome. The meticulously researched Zocdoc database can help you with this.
With Zocdoc, you can book in-person or online appointments with just a few clicks. Go to the Zocdoc website or download the application and type in your location, symptoms or condition, insurance provider, and a preferred date if you know it. For example, if you live in San Diego and want to see a doctor after noticing blood in your stools, type in this information.Â
Zocdoc will immediately show you a curated list of gastroenterologists. If you select a particular gastroenterologist, you can peruse through all relevant information regarding the doctor’s qualifications, certifications, awards, and verified narratives by past patients detailing their experience. By clicking on the drop-down menu on insurance, you will quickly know if a gastroenterologist you prefer is in-network with your insurance.
You can easily manage multiple insurance plans, including medical, dental, and vision, on your Zocdoc account. You can select only one plan at a time when scheduling an appointment. If you have secondary insurance, note it in the booking section. You can add secondary insurance details online if your healthcare provider uses Zocdoc's intake forms. If you have any additional inquiries or need guidance on managing your insurance, Zocdoc's patient help center can assist you with all insurance-related concerns.
Booking appointments with a gastroenterologist near you through Zocdoc is fast, free, and secure.
Colorectal cancer statistics in California
According to the American Cancer Society, less than 5% of all polyps become malignant, leading to colorectal cancer. However, regarding diagnosis, colorectal cancer is the third most common cancer in the US.
According to a report by the American Cancer Society, the percentage of screening tests for colorectal cancer in California stood at nearly 73% in 2018. California came among the states with the highest usage of these tests, which was between 73% to 76%.
A study published by the National Center for Biotechnology Information attempted to measure the incidence of colorectal cancer in young adults in California. The study included 5,617 young adults from the California Cancer Registry. They were between 20 and 39 years old and assessed based on gender, race/ethnicity, and tumor location.Â
The study concluded that even though the absolute incidence of colorectal cancer is far lower among young adults compared to the customarily screened population, which is adults 50 years and older, the incidence rates were, unfortunately, increasing as opposed to decreasing trends seen in the incidence rates of adults above 50 years.
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