7 Signs It's Time to See a Gastroenterologist

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If you have unexplained or frequent digestive issues, such as abdominal discomfort or changes to your bowel habits, someone's probably been told to see a gastroenterologist, also sometimes referred to as a GI doctor.

But if you've never seen a gastroenterologist before, you may be unsure whether your digestive symptoms really warrant seeing a specialist. You might even be wondering: What is a gastroenterologist?

Dr. Kerri Glassner, a gastroenterologist at Houston Methodist, explains everything you need to know if you're deciding whether it's time to see one, including what to expect at your first appointment.

What does a gastroenterologist do?

A gastroenterologist is a specialist with expertise in the disorders and diseases that affect the digestive system — which includes the gastrointestinal tract (esophagus, stomach, small intestine, large intestine, rectum and anus) as well as the pancreas, liver, bile ducts and gallbladder.

The digestive disorders and issues that a gastroenterologist treats include:

  • Unexplained changes in bowel habits, including diarrhea, constipation and blood in the stool
  • Gastroesophageal reflux disease (GERD)
  • Heartburn
  • Hemorrhoids
  • Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis
  • Irritable bowel syndrome (IBS)
  • Pancreatitis
  • Ulcers

"Gastroenterologists are trained to perform a number of procedures used to help diagnose and treat these conditions, such as upper endoscopy, colonoscopy, biopsy and the various endoscopic techniques needed to visualize the digestive system, including endoscopic ultrasound," explains Dr. Glassner.

When should you see a gastroenterologist?

Here are seven reasons to consider seeing a gastroenterologist:

1. Ongoing diarrhea

From food to infection to certain medications, many things can bring on a bout of diarrhea. However, if your stool is regularly more liquid than solid, it's time to check in with a GI doctor.

"Chronic diarrhea can be an indication of a few different digestive disorders, including IBS, IBD or small bacterial overgrowth (SIBO)," says Dr. Glassner. "IBS is the most common cause of chronic diarrhea. Fortunately, there are many treatment avenues your doctor can use to help manage your symptoms."

2. Constipation

The frequency of bowel movements ultimately varies from person to person, but Dr. Glassner says that less than three a week is typically considered constipation. You might also be constipated if your bowel movements are very small, very hard or difficult to pass.

If you're constipated more weeks than not, consult a gastroenterologist.

"Constipation can have many causes and it can be hard to manage on your own at home," says Dr. Glassner. "A GI specialist can help determine the likely cause of your constipation and recommend the lifestyle changes and medications that can help make your bowel movements more regular."

3. Frequent or severe heartburn

Getting heartburn now and then shouldn't be a matter of huge concern, and the good news is that occasional heartburn can typically be managed yourself at home.

But if you're having heartburn symptoms more than a couple of times per week, it could be a sign of GERD — a condition that, over time, can damage and scar the lining of the esophagus.

"Chronic acid reflux doesn't go away on its own, so it's important to be evaluated by a specialist," says Dr. Glassner. "Left untreated, GERD can cause permanent damage to the esophagus. This damage can lead to issues swallowing, cause painful ulcers and even increase a person's risk of developing esophageal cancer."

4. Feeling unusually bloated

Bloating, which can feel like your belly is full or tight, is often caused by issues that result in excess gas production, hypersensitivty to gas or gas being trapped in your colon.

"Constipation can cause bloating since the longer waste stays in your colon, the more likely it is to be fermented by resident bacteria, which creates gas," explains Dr. Glassner. "But bloating can also be a sign of IBS, a food sensitivity such as lactose intolerance, SIBO (small intestinal bacterial overgrowth) or gastroparesis (partial paralysis of the stomach)."

A gastroenterologist can help you identify what exactly is the cause of your bloating and the most effective way to treat it.

5. Sudden or severe abdominal pain

We've all dealt with bellyaches, but severe abdominal pain that lasts for hours or abdominal pain that comes on suddenly and intensely isn't normal.

"A stomach ulcer or peptic ulcer, which is a sore on the lining of your stomach or first part of your small intestine can lead to burning abdominal pain, particularly after eating," says Dr. Glassner. "An untreated ulcer can cause swelling and scarring that blocks your digestive tract."

Consistently severe abdominal pain can also be a sign of gallstones, pancreatitis or liver disease. A gastroenterologist can help determine the cause of your pain.

6. Rectal bleeding or blood in your stool

If you see blood on your toilet paper or as you flush the toilet, it could be hemorrhoids — a fairly common issue that can typically be managed with at-home remedies or over-the-counter products.

"However, if hemorrhoids aren't responding to these treatments or you're getting them frequently, a gastroenterologist can recommend more advanced treatments that can be help you get relief," Dr. Glassner adds.

Additionally, don't assume that blood in the toilet can only mean hemorrhoids.

"Any time you see blood in your stool or have rectal bleeding that is accompanied by changes in your bowel habits or to the color or consistency of your stool, it's critical that you see a gastroenterologist," warns Dr. Glassner. "Rectal bleeding isn't always a huge concern, but it can be a sign of a serious medical condition such as colorectal cancer."

7. You're due for a colonoscopy

If you're over the age of 45 or have a strong family history of colorectal cancer, you've probably heard your doctor recommend a colonoscopy.

"Most people begin having screening colonoscopies at age 45," says Dr. Glassner. "From there, the frequency varies based on your results — but if the findings are normal and you have no other risk factors, you only need to repeat a colonoscopy every 10 years."

And while a colonoscopy might sound uncomfortable, it can save your life. Early detection of colorectal cancer is important — when caught early, it can lead to less aggressive treatment and better chance of survival.

What happens at a gastroenterology appointment?

If you've noticed any of those seven signs, it's time to consider scheduling an appointment with GI doctor.

At your first appointment, your gastroenterologist will:

  • Ask you about your digestive symptoms and medical history
  • Recommend any lifestyle changes or medications that can help relieve your symptoms
  • Discuss any tests, screenings or procedures that may be needed

You may find it helpful to make a list of your symptoms before your appointment so that you don't forget to ask about any of the issues you're having.

"Through this initial evaluation, your doctor will start the process of uncovering the cause of your digestive issues and begin addressing your symptoms," Dr. Glassner explains. "If your condition is chronic, he or she will also discuss how best to manage your condition over time. Your doctor may also talk to you about additional testing that may be needed if your symptoms don't improve."

Feb. 1, 2022