An upset tummy or diarrhea. Frequent heartburn. A sudden and urgent need for the bathroom immediately after a meal. Abdominal pain and bloating or constipation. Any and all of these symptoms might signal that there’s something amiss in your digestive system, and depending on what exactly you’re experiencing and how long those symptoms have lingered, it might be time to seek the assistance of a gastroenterologist.
The American College of Gastroenterology notes that gastroenterology encompasses “the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver.” Gastroenterologists, also sometimes called GI doctors, are specialist physicians who’ve had extensive training — typically six years after completing medical school — in internal medicine and gastroenterology that enables them to care for patients with a wide range of diseases that affect several critical organs.
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Dr. Edward Levine, a gastroenterologist with The Ohio State University Wexner Medical Center in Columbus, says some of the most common conditions for which patients seek help from a gastroenterologist are “what we call functional bowel diseases: things like irritable bowel syndrome,” a condition that causes belly pain, constipation and diarrhea. “This is probably the most common condition that we see, and it’s usually in the outpatient clinic. Most people with irritable bowel are not admitted to the hospital.” The National Institute of Diabetes and Digestive and Kidney Diseases reports 12 percent of people in the U.S. (nearly 40 million people) have IBS.
A potentially more serious condition called inflammatory bowel disease is also relatively common. IBD is generally grouped into two main categories — ulcerative colitis and Crohn’s disease. Both conditions feature chronic inflammation of the digestive tract. The Centers for Disease Control and Prevention reports that about 3 million Americans have IBD.
There are lots of other conditions and diseases that might send you in search of specialized help, ranging from heartburn (also called gastroesophageal reflux disease or GERD) and peptic ulcers to chronic diarrhea, hemorrhoids, celiac disease, lactose intolerance, gallbladder disease and liver diseases like cirrhosis and Hepatitis C. If you’ve tried over-the-counter treatments, such as antacids or antidiarrheal medications, or already sought care from your primary care physician but your symptoms have not improved, it might be time for more specialized help, says Dr. Michael Komar, director of the Division of Gastroenterology at Geisinger Medical Center in Danville, Pennsylvania. “I think if people have had their symptoms for a period of time and they’ve seen the primary care provider but things just aren’t getting better, that’s probably a good time to see a gastroenterologist.”
Depending on the condition you’re dealing with, a gastroenterologist may be able to prescribe a range of medications that can alleviate symptoms. For heartburn and other conditions where stomach acid is causing damage, such as Barrett’s esophagus, gastritis and peptic ulcers, “we may be using anti-secretory medications,” such as proton pump inhibitors, “to decrease the acid secretion,” Levine says. For IBD and other conditions that involve chronic inflammation, anti-inflammatory medications may be in order. These would include “steroids and immunomodulators — medications that suppress the immune system,” he says. “There’s another group of drugs called biologic medications, which include Remicaid [infliximab] and Humira [adalimumab]. These are used to treat people with inflammatory bowel disease.”
Levine says he also “likes to use dietary therapy, so putting people on a high-fiber diet” when possible rather than simply prescribing medications. Fiber adds bulk to the stool, which can help move waste through your digestive system more regularly. This can help alleviate some of the symptoms of IBS and IBD. Avoiding spicy foods or foods that are known to exacerbate acid reflux, such as coffee, alcohol, garlic, citrus fruits and tomatoes may also help you manage GERD and other digestive issues.
[See: How Often Should I Poop, and Other Toilet Topics.]
In addition to treating a known digestive issue, visiting a gastroenterologist may also be a good option when you need to start routine colonoscopy screening for colon cancer, Komar says. During a colonoscopy, the doctor inserts a long, flexible tube with a camera and light at the end into the large intestine. This allows the doctor to see inside the colon and rectum to look for growths (polyps) and other abnormalities that could signal cancer. It’s not the easiest procedure to perform, and practice makes perfect. “Gastroenterologists receive a lot of dedicated training in endoscopy, upper endoscopy and colonoscopy by expert instructors,” and likely have more expertise than some other physicians might, Komar says. “Like in any profession, the more you do something, the better you are at it.” And if your colonoscopy turns up evidence of a polyp, the gastroenterologist can remove it for you, too, which may reduce your risk of developing colon cancer.
When it comes time to find the right gastroenterologist for your needs, asking family, friends and your primary care doctor who they would recommend can be a good place to start. Komar also recommends using the ACG’s online search tool to look for a board-certified doctor in your area. Consider whether you’d feel more comfortable working with a male or female doctor — Komar says more women are coming into the field and some health centers and hospitals have established women-focused centers where all the providers are female.
Gender aside, in selecting the right doctor, Komar says it’s important to find a doctor you can engage with and with whom you feel comfortable. “If you get a doctor who listens, and the patient can develop that good relationship, that makes everything better. If it seems like the doctor was rushed or wasn’t that interested or cut you off, in the end that just leads to care that’s not as good,” he says. If you experience that, consider moving on to a different provider.
[See: 10 Questions Doctors Wish Their Patients Would Ask.]
Levine agrees that finding a good personality fit is important because depending on the condition you’re dealing with, the relationship you develop with your gastroenterologist could turn out to be long term. “We’re taking care of people who have chronic diseases, and these are people we see a lot, whether it’s irritable bowel syndrome or inflammatory bowel disease,” he says, noting that he still sees a few patients that he first started treating in 1992 when he arrived at Ohio State. “Consider that continuity of care.”
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Which Doctor Should I See for Digestive Issues? originally appeared on usnews.com
