What Is a Gastroenterologist?

A gastroenterologist is a physician who specializes in diseases of the digestive system, also called the gastrointestinal (GI) tract. Gastroenterologists have extensive training in the diagnosis and treatment of conditions that affect the esophagus, stomach, small intestine, large intestine (colon), and biliary system (e.g., liver, pancreas, gallbladder, bile ducts). Gastroenterology is a subspecialty of internal medicine.

Gastroenterologists have a thorough understanding of how food moves through the digestive tract (called motility) and the physical and chemical break down of food (digestion), including the absorption of nutrients and the removal of waste products. Gastroenterologists also focus on the digestive function of the liver.

Gastroenterologists usually care for patients in an office or hospital setting, including nursing homes and outpatient surgical centers. They often serve as consultants to other physicians and may work in the research field. Gastroenterologists specialize in the evaluation, diagnosis, management, and treatment of the following symptoms and conditions:

• Abdominal pain and discomfort
• Bleeding in the digestive tract
• Cancer (e.g., colorectal cancer, stomach [gastric] cancer, pancreatic cancer, liver cancer)
• Constipation and diarrhea
• Difficulty swallowing
• Diverticular disease and other diseases of the colon (e.g., polyps, irritable bowel syndrome [IBS], colitis, Crohn's disease)
• Gallbladder disease
• Heartburn and gastroesophageal reflux disease (GERD)
• Hemorrhoids
• Hiatal hernias
• Inflammation in the digestive tract (e.g., gastritis)
• Liver disease (e.g., hepatitis, jaundice)
• Malabsorption disorders (e.g., celiac disease, lactose intolerance)
• Stomach upset, nausea, vomiting
• Ulcers
• Unexplained weight loss

Education and Training

A minimum of 13 years of education and extensive training is required to become a gastroenterologist. Students interested in gastroenterology should focus on undergraduate courses in biology, chemistry, and mathematics. After attaining an undergraduate degree (e.g., Bachelor of Science) or a postgraduate (advanced; e.g., Master's) degree, most students attend a 4-year medical school. Upon graduation from medical school, physicians are awarded either a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree.

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The next step in becoming a gastroenterologist is a 3-year program of special study and training called a general internal medicine residency. Following completion of this residency, the physician (internist) may continue on to specialize in gastroenterology by entering a gastroenterology fellowship.

A gastroenterology fellowship is an intense 2- or 3-year program, during which the physician receives extensive training in diseases and conditions of the digestive tract. Organizations such as the American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology, and the American Gastroenterological Association oversee gastroenterology fellowships to ensure a high quality of education and training.

Gastroenterology fellowships include instruction and training in the following:

• Caring for patients in different settings (e.g., doctor's office, hospital)
• Evaluating and treating patients with GI symptoms and conditions
• Performing diagnostic procedures (e.g., endoscopic procedures, such as colonoscopy, upper endoscopy, sigmoidoscopy)
• Providing recommendations to help prevent disease and maintain good health

During this fellowship, physicians learn how to perform complicated procedures, such as polyp removal (called polypectomy), stretching (dilation) of the esophagus and intestines, and various techniques to stop bleeding in the GI tract. They also learn how to administer sedation required for these procedures and how to interpret results.

Certification

Following completion of this training, gastroenterologists are highly-trained specialists with a comprehensive understanding of the digestive system. These physicians are considered "Board Eligible" and can then take the gastroenterology certification exam, which is administered by the American Board of Internal Medicine. Physicians who successfully complete this examination are Board Certified in gastroenterology. Gastroenterologists also can be certified by the American Board of Colon and Rectal Surgery.

Physicians who meet the difficult requirements of the American College of Physicians or the American College of Gastroenterology may receive special recognition from these organizations. These physicians (known as "Fellows") can include the initials FACP (Fellow of the American College of Physicians) or FACG (Fellow of the American College of Gastroenterology) after their names. Gastroenterologists are experts in the care of patients who have disorders of the digestive system, or gastrointestinal (GI) tract. They are highly-trained specialists who can provide comprehensive medical care to these patients.

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