Gastroenterologists are physicians specializing in the digestive system, which includes the esophagus, stomach, small intestine, large intestine, liver, pancreas, and gallbladder. While they are highly skilled in a wide array of procedures, the direct answer to whether they perform surgery is generally no. They are medical specialists focused on the diagnosis and non-surgical treatment of gastrointestinal diseases, utilizing medical management and interventional techniques.
The Definitive Role of a Gastroenterologist
A gastroenterologist’s primary practice involves the medical management, long-term care, and diagnosis of complex digestive disorders. They complete a three-year residency in internal medicine followed by an intensive three-year fellowship focused exclusively on digestive health and disease. This extensive training establishes them as experts in conditions managed primarily through medication, diet, and lifestyle adjustments. Common conditions treated include Irritable Bowel Syndrome (IBS), gastroesophageal reflux disease (GERD), Celiac disease, and inflammatory bowel diseases (IBD) like Crohn’s disease and ulcerative colitis. They also handle ailments of the liver, such as hepatitis, and disorders of the pancreas and bile ducts.
Procedures Performed by Gastroenterologists
The perception that gastroenterologists perform surgery often stems from the specialized, interventional procedures they routinely conduct, which are technically non-surgical. These procedures utilize flexible, lighted tubes called endoscopes to examine and treat the digestive tract without making a major external incision. The most common procedures are upper endoscopy (EGD) and colonoscopy, which allow for both diagnosis and therapy, often preventing the need for true surgery. For example, during a colonoscopy, a gastroenterologist can perform a polypectomy, which is the removal of precancerous polyps using specialized tools passed through the scope. They also perform Endoscopic Retrograde Cholangiopancreatography (ERCP) to diagnose and treat issues in the bile ducts and pancreas, such as removing gallstones or placing stents.
When Surgery is Required: The Role of the GI Surgeon
When a digestive condition requires an open incision or the removal of an entire organ or a large section of tissue, the patient is referred to a Gastrointestinal (GI) Surgeon or a Colorectal Surgeon. These surgeons complete a five-year surgical residency after medical school, focusing on operative techniques for treating disease. They are the specialists who perform true surgical interventions, which involve breaching the body’s cavity to access and repair internal organs. Scenarios demanding a surgeon’s expertise include the removal of large or deeply invasive tumors and cancers that cannot be safely managed endoscopically. A GI surgeon performs organ resection, such as removing a diseased section of the bowel in cases of complicated inflammatory bowel disease or colon cancer.