Do You Need A Colorectal Surgeon or Gastroenterologist?

If you have inflammatory bowel disease (IBD), you may, at times, be unsure which specialist to call about your Crohn's disease or ulcerative colitis. When you're living with either of these conditions, it's important to regularly see a primary care physician, and you may also need to see a gastroenterologist and a colorectal surgeon.

Some people with IBD see their colorectal surgeons more often than they see their gastroenterologist—and the reverse is also true. There are several aspects to consider when it comes to which specialist may be needed. This article will describe the role of colorectal surgeons and gastroenterologists in IBD care, which may help you understand which aspects of your IBD care might be more appropriate for one or the other specialty.

Why People With IBD May Need A Colorectal Surgeon

You may be referred to see a colorectal surgeon for several different reasons. If you are sent by a gastroenterologist to talk to a colorectal surgeon, it doesn't always mean that you are headed for surgery.

• Your gastroenterologist might send you for a surgical consult to determine if your Crohn's disease or ulcerative colitis are at a point where the disease would be better managed through surgery.
• A colorectal surgeon may not always advise that surgery is the best course of action. Sometimes a surgeon is consulted to give a better understanding of the surgical options and may determine that it's better to wait for surgery or that surgery is not a good option at all.
• During your recovery and after you heal from surgery, your surgeon will follow up with you to check whether you have signs of complications such as an abscess, fistula, ileus, intestinal blockages, or adhesions.
• After IBD surgery, you would stay in contact with your colorectal surgeon for some time, especially if the surgery was for ostomy or j-pouch surgery.

In addition to these issues, sometimes IBD causes serious issues, such as intestinal blockage, that could require urgent surgical intervention.

Why People With IBD Need A Gastroenterologist

Gastroenterologists are the physicians who will coordinate most of the care for managing IBD. For the most part, IBD is managed with medications and it is often necessary to have a specialist make recommendations on these treatments.

All gastroenterologists receive training in caring for patients with IBD, and some gastroenterologists specialize in IBD or see patients at IBD centers. For day-to-day concerns about IBD, including managing symptoms (such as diarrhea, bloody stools, constipation, or pain), addressing medication side effects, or coordinating care or referrals for extra-intestinal manifestations (which may include skin, eye, or join problems), a gastroenterologist will be the primary point of contact.

Even if you have surgery for treatment of your IBD, your gastroenterologist would also be kept in the loop to manage your medical therapy before, during, and after any surgery.

Procedures and Tests

When it comes time to have a colonoscopy or other endoscopic procedure, either a colorectal surgeon or a gastroenterologist may do the test. Which doctor conducts the procedure will be based on the customary protocol in the clinic or hospital where you get your care.

A Third Option: Enterostomal Therapy Nurse

An enterostomal therapy (ET) nurse is a specialized healthcare provider who helps with the care of ostomy (ileostomy or colostomy). An ET nurse has training in assisting patients with their needs before, during, and after ostomy surgery.

If you have a stoma, when you have questions about peristomal skin, ostomy appliances, or other ostomy concerns, an ET nurse may be your first point of contact.

Colorectal Surgeons

A colorectal surgeon is a surgeon who has specialized in treating diseases of the colon and rectum and is also sometimes called a proctologist. To become proficient in the treatment and management of these digestive conditions, a colorectal surgeon must complete 4 years of medical school after college, then undergo 5 to 6 years of training in general surgery, followed by one to three years of advanced training in specialized surgery of the lower digestive tract.

Gastroenterologists

In order to become a gastroenterologist, physicians must complete medical school, a 3-year residency in Internal Medicine, and then a 3-year gastroenterology fellowship. A physician receives specialized training in the diagnosis, management, and treatment of diseases and conditions of the gastrointestinal tract during their gastroenterology fellowship. Further training is necessary if a gastroenterologist decides to pursue more specialized training in hepatology (liver disease), advanced endoscopy (advanced endoscopic procedures), or IBD.

Locate a Colorectal Surgeon

Finding a colorectal surgeon can be tricky in some areas of the country. You can use the American Society of Colon and Rectal Surgeons and Canadian Society of Colon and Rectal Surgeons resources to help find a specialist physician that is working in your area.

Locate a Gastoenterologist

The ACG provides an online locator to find local gastroenterologists. A hepatologist can be found using the liver specialist locator. Patients can check on a physician's board certification through an online verification portal maintained by the American Board of Medical Specialties (ABSM).

A Word From Verywell

With IBD, it can be challenging to know which specialist to call for routine care or when you have a problem. At times, one specialist might suggest that you see another specialist. Sometimes your internist, family physician, or primary care physician is the person you need to talk to first, especially if you aren't sure whether your problem is related to your IBD. In most cases, your gastroenterologist is your main point of contact unless it's clearly a surgical problem. With your ongoing IBD care, different providers will be part of coordinating your medical and surgical treatments to keep your condition well-controlled.