In some cases, a referral to a digestive specialist may be helpful
Upon noticing new signs or symptoms in the digestive system, such as constipation, diarrhea, heartburn or abdominal pain, there might be a question as to what doctor to see: a family doctor, an internist, or a digestive specialist (a gastroenterologist). Which doctor to see at the start of any new symptoms, as well as after getting a diagnosis, is going to vary based on a number of different factors. In some cases, it might be clear when to see a gastroenterologist, but in others, there might be some wiggle room.
When Digestive Symptoms Are New
For digestive symptoms that are occurring for the first time, the first step may be to get an appointment with a family physician, primary care physician, or internist. Ideally, this is a physician with whom there is already a relationship and who has a working knowledge of the medical history. Once the new symptoms are described, the doctor can then do a physical exam and determine what tests (if any) should be done first in order to find out what may be causing the symptoms.
At this point, there will be some decisions to make based on the results of a physical exam, lab tests, or imaging studies. If the doctor decides that the symptoms need the attention of a specialist, it may be time to see to a gastroenterologist. A primary care physician or internist will be able to make a referral. However, if the diagnosis is a common one, is easily treatable and/or is not likely to recur, it may be fine to work with an internist or primary care physician without seeing a gastroenterologist.
When a Digestive Condition Is Already Diagnosed
In many cases, people who are diagnosed with a chronic (ongoing) digestive condition are under the long-term care of a gastroenterologist. In the event of a recurrence or a flare-up of an existing condition, such as Crohn’s disease, ulcerative colitis, or irritable bowel syndrome, contacting the gastroenterologist who has been managing the treatment will be the best choice. The gastroenterologist should also be talking with any other physicians involved, and give regular updates on any progress.
Gastroenterologists also treat diseases of the liver and the pancreas. If a disease such as hepatitis or pancreatitis is suspected, a referral to a gastroenterologist for treatment may be needed.
Routine Referrals for Screenings
A primary care physician may also refer a patient to a gastroenterologist for routine tests, such as a colonoscopy to screen for colorectal cancer in people who are older than 50 years (or younger, when appropriate).
Insurance Coverage for Specialists
Many insurance carriers require a referral to a specialist. Without a proper referral, the insurance company may not cover the costs associated with a visit to a specialist. In this case, it is necessary to first see a primary care physician (for women, this may include a gynecologist) and be referred to a gastroenterologist. Other insurance carriers do not require a referral, and patients may make their own appointments with a specialist. Check with the insurance carrier (the phone number will be on the back of the insurance card) if there’s any question about requiring a referral, as well as to find out if the referral doctor is on the plan.
In most cases, patients must first see a general practitioner or another specialist and be referred to a gastroenterologist. It may not be possible to make an appointment with a gastroenterologist without a referral.
When the Closest Gastroenterologist Is Hours Away
In some areas, there may not be a gastroenterologist close by. Seeing one on a regular basis may require a certain amount of travel. This can be a hardship, but it should be taken into consideration that a gastroenterologist has a significant amount of specialized training in digestive diseases and conditions. When the diagnosis is a chronic digestive disease that requires careful management, a gastroenterologist will have the experience needed to recommend a comprehensive treatment plan.
Conditions Managed by a Gastroenterologist
A gastroenterologist is specially trained to manage diseases of the digestive tract from the esophagus to the anus. Some conditions that a gastroenterologist may treat include:
- Celiac disease
- Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
- Irritable bowel syndrome
- Gallbladder disease
- Heartburn (gastroesophageal reflux)