What Do Gastroenterologists Do

By David Krug David Krug is the CEO & President of Bankovia. He's a lifelong expat who has lived in the Philippines, Mexico, Thailand, and Colombia. When he's not reading about cryptocurrencies, he's researching the latest personal finance software. 4 minute read

One of the highest-paid medical specialties is gastroenterology, which focuses on the digestive system. In the event that you’re thinking about becoming a gastroenterologist, you may be wondering how narrowly you should narrow your focus. In reality, it’s up to the individual practitioner to make that decision. While some gastroenterology specialists focus on the entire digestive system, others specialize in a specific part of the digestive system. As a gastroenterologist, you can choose to specialize your career by focusing on a specific medical condition or procedure or intervention. There are a number of subspecialties in gastroenterology, including colonoscopy, hepatology, and pediatric gastroenterology, but many more subspecialties are emerging.

Gastroenterology as a whole

If you want to practice gastrointestinal medicine to the fullest extent possible, you can. Despite the digestive system’s size, which includes more than a dozen components, gastroenterologists are still able to diagnose and treat conditions that affect the entire system. Internal medicine already has a specialization in general gastroenterology. A wide range of internal diseases affect adult patients in the field of internal medicine, but pediatric gastroenterology is also an option.

An important part of general gastroenterology is the examination of the esophagus and stomach as well as the intestines, rectum and anus, as well as their structure, function, and disease. Besides the liver, pancreas, gallbladder, and salivary glands, the digestive system includes other organs like the liver, pancreas, and pancreatic ducts. However, dentists are more commonly responsible for oral cavity issues, according to Healthline.

Medical experts at the American Medical Association say that without further specialization, you can treat a wide range of gastrointestinal problems, including stomach ulcers and abdominal pain. The endoscope is an essential diagnostic and treatment tool in gastroenterology. Gastroenterologists can use these tiny cameras attached to long tubes that are small enough to pass through your body to view and, in some cases, treat patients’ internal organs in non-surgical procedures known as endoscopies.

Starting out as a general gastroenterologist, you may later decide to specialize in a particular area of interest, developing a deeper understanding of the field as you gain more experience.

Gastroenterology has a number of subspecialties.

An individual gastroenterologist may specialize in a specific disease, such as Irritable Bowel Syndrome (IBS), or in a larger area of practice, such as hepatology, the management of liver and liver diseases. Pediatrics, gastroenterology interventions in clinical pharmacology, or endoscopy procedures like transplants and specialized endoscopy may also be areas of interest.

The fields of colonoscopy, hepatology, and pediatric gastroenterology are among the more well-established subspecialties of gastroenterology. The BMJ, a global general medical journal, reports that other subspecialties have a narrower focus and are still developing. Gastrointestinal oncology, for example, involves treating patients with digestive system cancers. Both tropical and pancreatic disease can be studied. Those who specialize in neurogastroenterology treat patients with gastrointestinal symptoms brought on by neurological conditions such as multiple sclerosis and do extensive research into the relationship between the gut and the brain.

There are advantages to being a specialized gastroenterologist even for general practitioners. GI & Hepatology News reported that gastroenterologists who provide nutrition support can help their patients better manage gastrointestinal conditions like small-bowel disorders.


As a preventative measure, a colonoscopy is a medical procedure that screens for colon cancer. Colonoscopists use scopes to examine the rectum and colon for polyps, which are potentially cancerous or precancerous tissues or lesions, and to remove them. Small polyps can often be removed during a colonoscopy by a skilled colonoscopist, but larger polyps may necessitate a surgical procedure.

The American College of Gastroenterology reported that while all board-certified gastroenterologists are required to complete extensive training in performing colonoscopies, not all colonoscopists are gastroenterologists. For a colonoscopy, a gastroenterologist is more likely to miss cancerous or precancerous polyps or to cause complications such as bowel perforation than a doctor who is not a gastroenterologist.

Colonoscopy training is mandatory for all board-certified gastroenterologists, so it doesn’t sound like a specialty. Colonoscopies can be performed by any doctor, including gastroenterologists. However, not all doctors are equally proficient in the procedure. The medical journal Gastrointestinal Endoscopy reported that adenoma detection rate (ADR) and polyp detection rate (PDR) are used to evaluate a physician’s skill in performing this procedure. Colonoscopy specialization may not necessarily imply completing different training programs than other gastroenterologists, but rather a substantial amount of experience performing the procedure and a high rate of polyp and adenomas detection during the procedure.

When a gastroenterologist performs a colonoscopy, the death rate from colon cancer drops by 65 percent, whereas only 57 percent and 45 percent are reduced when the procedure is performed by primary care doctors or surgeons.


According to the American College of Physicians, if you want to specialize in transplant hepatology, you can get the necessary advanced training and certification. This branch of medicine deals with advanced liver disease, including hepatitis and alcoholism-related liver disease. This specialty may require you to concentrate on performing liver transplants, as well as preparing patients for the procedure and providing post-operative care for those who have undergone the transplant.

More than 11,000 patients are on the waiting list for liver transplants in the United States, according to the Mayo Clinic, which performs about 8,000 liver transplants per year.

Gastroenterology in Children

Digestive system problems affect people of all ages. Pediatric gastroenterology may be the right subspecialty for you if you enjoy working with and caring for children. These specialists are trained to address the digestive tract issues that affect children, which may include issues related to the development of their digestive tract. Even though a child’s digestive system has the same components as an adult’s, according to the American Academy of Pediatrics, it also continues to develop through adolescence. Infants and toddlers who have chronic diarrhea, celiac disease, lactose intolerance, or other food allergies may benefit from your expertise as a pediatric gastroenterologist.

According to the American Medical Association, the Accreditation Council for Graduate Medical Education has accredited two pediatric gastroenterology and pediatric transplant hepatology specialty training programs.

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