What is a Gastroenterologist (GI Doctor)?

The GI, or gastrointestinal system, includes the organs of the digestive tract: the mouth, esophagus, small and large bowel, rectum, and anus. It also contains the organs of the biliary system: the pancreas, liver, gall bladder, and bile ducts. All these organs work together to digest and metabolize food, clear out toxins, and maintain fluid balance.

The training to become a GI doctor is extensive. After completing an undergraduate degree, an aspiring GI doctor needs to take four years of medical school. The next step is a three-year general internal medicine residency to learn more about the diagnosis and treatment of complicated conditions. Following this, the physician will need two to three years of gastroenterology fellowship training. During this fellowship, doctors learn specific diagnostic issues and procedures for the gastrointestinal system.

Some GI doctors complete yet another year to specialize in liver transplants, inflammatory bowel diseases, or surgery and specific GI procedures. Some gastroenterologists choose to also specialize in hepatology and proctology. Hepatology involves the liver and related organs. Proctology encompasses the rectum and anus, the very end of the large bowel responsible for expelling stool.

A referral from a general practitioner is usually required to see a gastroenterologist. A family doctor will refer patients based on the presence of specific signs and symptoms including constant pain in the abdomen, bleeding from the anus, persistent nausea, swelling of the stomach, heartburn, weight loss, excessive gas, and vomiting without an apparent cause. Other signs to watch for are lumps or hoarseness in the throat, which may indicate a problem with the esophagus. Also, black stool may be a sign of bleeding in the stomach or small intestine.

The stomach is responsible for breaking down food into a liquid form and passing it to the small intestine. It also absorbs or breaks down certain nutrients and medications. Conditions related to the stomach that a GI doctor would diagnose and treat are heartburn, ulcers, inflammation of the stomach, certain cancers, and disorders of stomach movement, also called gastrointestinal motility disorders, such as IBS and gastroparesis.

The bowel consists of the small and large intestines. They are responsible for breaking down food into even smaller parts and absorbing the nutrients to benefit the body. They also excrete waste products and maintain fluid balance. Some bowel conditions that a GI doctor can help address include cancer, inflammatory bowel diseases, polyps, ulcers, constipation, diarrhea, and disorders of movement or absorption.

Other conditions a gastroenterologist may be called upon to diagnose and treat include hemorrhoids, gall bladder disease, hernias, severe parasitic infections, and liver or pancreas problems. Sometimes a GI doctor will partner or consult with other specialists regarding conditions related to the gastrointestinal system. For example, an ear, nose and throat specialist may weigh in on severe cases of acid reflux that cause problems with the throat before it connects to the esophagus.

Gi doctors are trained to perform several tests and physical exams to diagnose conditions, including endoscopies and colonoscopies, tests that require inserting a camera into the stomach and bowel to see what is happening internally. Gastroenterologists also perform biopsies to look at polyps or tumors growing inside the digestive tract. Lastly, they may order ultrasounds or other imaging tests to search for obstructions or changes in the gastrointestinal system.

Gastroenterologists usually get their referrals from regular family doctors and will work with them to monitor the progress of patients with GI disorders. They also work with other specialists if conditions are related to or complicated by a GI issue. An example is a GI doctor who works in partnership with an oncologist (a doctor specializing in cancers) to diagnose and treat bowel cancer. Gastroenterologists often work with ear, nose and throat doctors, gynecologists, and other GI specialists such as proctologists.

Gastroenterologists or GI doctors work primarily in hospitals, where they can be available for tests, procedures, surgeries, and consultations. Many also have an office or private practice where they take appointments with new or existing patients. Also, GI doctors are often involved in teaching hospital residents, so they may work at local universities or residency programs within the hospital.