What is a Gastroenterologist? what to Expect on a Visit

Are you about to see a gastroenterologist for the first time? You’re in good hands. Because they specialize in digestive diseases, gastroenterologists treat lots of people who have symptoms just like yours.

What Is a Gastroenterologist?

Gastroenterologists are internists (doctors trained in internal medicine).

They complete up to 6 more years of specialized training after medical school. These doctors study the digestive system and any diseases that affect your esophagus, stomach, gallbladder, pancreas, liver, intestines, colon, and rectum, like these:

• Cirrhosis
• Colon polyps and colon cancer
• Constipation and diarrhea
• Crohn’s disease
• Gallbladder disease
• Gastroesophageal reflux disease (GERD)
• Hepatitis
• Irritable bowel syndrome (IBS)
• Liver cancer
• Peptic ulcers
• Ulcerative colitis
• Pancreatitis

Your first appointment with your gastroenterologist will probably take 30-60 minutes. They’ll ask you about your symptoms, medical history, and any treatments you’ve tried. Other visits could be shorter.

Where Do Gastroenterologists Work?

Gastroenterologists may see patients in a hospital or an outpatient clinic. They aren’t surgeons, but they do tests, like a colonoscopy or endoscopy, at both of these places.

Your primary care doctor or family doctor may send you to a gastroenterologist. And you might need a referral from that doctor for insurance to cover the cost of your visit.

What Questions Will My Gastroenterologist Ask?

First, your nurse will check your blood pressure and heart rate, and ask you questions about your health. Tell them what medicines you take or if you have any allergies.

Your gastroenterologist should ask you more detailed questions like these:

• What are your symptoms?
• Where is your pain?
• How long does your pain usually last?
• Does your pain move around or change?
• When did your symptoms start?
• Do your symptoms get worse or better at certain times?
• Does anything seem to trigger your symptoms?
• Has anyone in your family had digestive diseases or other health problems?
• Have you had any other illnesses or surgery before?

Some questions may not seem to have anything to do with your digestive problem. But symptoms in other parts of your body can help the gastroenterologist make the right diagnosis.

You might want to make a list of your symptoms before you see the gastroenterologist. Bring it with you so you don’t forget anything.

Questions to Ask Your Gastroenterologist

You should ask questions, too. Here are a few you can try:

• Will I need any more tests?
• What are the usual treatments for my condition?
• Will I need a colonoscopy or endoscopy?
• What do I do if I have a symptom flare-up before I see you again?
• What are the signs of a serious complication?
• Are there any medications that could make my problem worse?
• Will I need to change my diet?

Your Physical Exam

The gastroenterologist will look at you to try to find the cause of your symptoms. You’ll lie on the exam table and relax. Your doctor will press down on the skin around your belly. They’ll listen for odd bowel sounds and feel for any masses or tenderness. They may ask you to take deep breaths or cough during your exam.

They might also put a finger into your rectum to feel for any bulges or masses, and to check the muscle tone.

What Are the Next Steps?

The gastroenterologist may send you for X-rays, a CT scan, or blood and stool tests. They may give you a stool test. Among other things, a stool culture can check how well your body absorbs and uses fat. They may also test your motility (how food moves through your digestive system).

The doctor might also suggest procedures to diagnose your problem. They’ll schedule these tests for later and tell you how to prepare:

Barium swallow or enema: Barium is a liquid that highlights areas inside your body on a scan. The doctor may give you barium to drink to check your esophagus, stomach, or upper small intestine. Or you may need one to check your colon or rectum. An X-ray will show the doctor your organs as they move.

Endoscopy: This long, thin tube with a tiny camera on the end goes through your mouth so the doctor can look at your upper digestive tract or take a biopsy (tissue sample). You may get an endoscopy if you have persistent heartburn, belly pain, vomiting, or other problems that don’t go away.

Colonoscopy: The doctor puts a thin scope with a camera on the end into your bottom. It goes into your colon, rectum, or large intestine to look for polyps or bleeding, get rid of any polyps, or take a biopsy. Your doctor may order a colonoscopy to check for problems such as inflammatory bowel disease, or problems that may cause changes in how often and how you poop, belly pain, or blood in your stool.

Enteroscopy: You may have this procedure if an endoscopy or a colonoscopy fails to find anything. You swallow a tiny video capsule that transmits pictures of the insides of your digestive tract. An enteroscopy may reveal causes of bleeding and ulcers (sores) caused by Crohn’s disease, among other things.

Medications

Your gastroenterologist may suggest over-the-counter antacids, or prescribe medications to treat your heartburn, gas, constipation, or other symptoms. They often prescribe proton pump inhibitors, H2 blockers, or metoclopramide, which helps with motility.

Lifestyle Changes

Your gastroenterologist may tell you to do these things to manage your symptoms:

• Cut back on caffeine.
• Don’t eat foods that trigger symptoms.
• Eat more fiber.
• Exercise regularly.
• Find ways to manage your stress.
• Poop when you have the urge.

What You Can Do to Help

Follow your gastroenterologist’s lifestyle tips to feel better, and get regular colon screenings to spot early signs of cancer.

Let the doctor know if you have blood in your stool, changes to your bowel movements, fatigue, or weight loss you can’t explain.

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