A gastroenterologist is a doctor of the digestive system, known as the gastrointestinal (GI) tract. The GI system includes the oesophagus (gullet), stomach, and all parts of the small intestine (duodenum, jejunum and ileum) and large intestine (colon and rectum). Liver and gallbladder conditions are also a large part of the caseload of a gastro doctor. Gastroenterology doctors treat conditions like stomach ulcers, irritable bowel syndrome, and cancers involving the stomach, throat, and intestines. Stomach doctors work in hospitals or specialist care centres, and run clinics within outpatient settings. Family doctors refer patients to gastroenterologists for any symptoms of the digestive tract that require specialist intervention, or that could indicate serious illness.
Gastro doctors look for symptoms like acid indigestion or ‘heartburn’, stomach or lower abdominal pain, jaundice, blood in stools or changes in bowel habits, to diagnose gastroenterology conditions. When conditions are diagnosed, gastroenterologists will suggest a course of treatment to cure or manage the problem. This may involve medication, lifestyle changes, or sometimes surgery. Medical gastroenterologists work closely with gastroenterology surgeons for conditions requiring surgery. Gastroenterologists enlist the help of specialist nurses, nutritionists and dieticians, pharmacists and radiologists to help to identify and treat conditions, and to educate and support any patient with a GI diagnosis. Sometimes the symptoms of stomach problems can overlap with symptoms indicating different problems, and so gastroenterologists may consult doctors from other specialities when trying to ascertain a diagnosis.
A gastroenterologist can become a pediatric gastroenterologist and specialize in the care of children with gastrointestinal diagnoses.
Stomach specialists can also be involved with public health efforts like recommending regular screening for bowel cancer to all people at risk, to aid early detection and make large-scale improvements to health in society.
Gastroenterologists perform diagnostic and therapeutic procedures for conditions affecting the digestive system. They perform endoscopies: non-surgical ways of looking inside the digestive system with a long flexible tube called an endoscope. Endoscopes use optical technology and light to help identify problems, and have ports for feeding very fine instruments through the tube to the problem areas to provide treatment right then and there. They endoscopic procedure for looking into the upper GI tract is called a gastroscopy, and an investigation in to the lower GI tract is called a colonoscopy – for the full large intestine and the very end of the small intestine (terminal ileum); or a sigmoidoscopy – for looking into just the last part of the large intestine.
Other investigations into the digestive system can include ultrasound, CT/CAT scans, MRI scans, capsule endoscopies, and sometimes investigative surgery.
People with long-term or serious conditions of the GI tract may need long-term monitoring, and can be seen regularly in a gastroenterology clinic, where they will have weight, height, and general medical observations taken as well as specific monitoring of their GI condition.
Many gastrointestinal conditions are manageable or avoidable with lifestyle changes, and stomach doctors may work in large-scale education programmes raise awareness of worrying stomach or bowel disease symptoms, to encourage a healthy diet, and reduce smoking and alcohol intake.