Most people put up with stomach trouble far longer than they should. A bit of acidity, some bloating, a dull ache after meals: it’s easy to treat all of it with antacids and a shrug. This article looks at who to see when it doesn’t go away, and uses two doctors from different corners of digestive medicine to show how the work is divided.
Why there are two kinds of doctors
I have learned that the digestive system, beginning at the food pipe and traveling through the stomach, intestines, liver, pancreas and gallbladder is cared for by two kinds of doctors.
I know that a gastroenterologist uses medicines, diet plans, tests and scopes. The gastroenterologist looks into what’s causing a problem and treats it without surgery whenever possible.
When a problem is physical or medicines can no longer help a gastrointestinal surgeon performs surgery, such as when a gallbladder has stones or a hernia is present.
I have seen many people visit both a gastroenterologist and a gastrointestinal surgeon at some point in their lives.
The first question, for each doctor is usually the same: what is actually causing this?
Two doctors, two roles
The details below come from the doctors’ own websites. We haven’t independently verified them, and this isn’t a recommendation of either doctor.
Dr. Vipulroy Rathod, gastroenterologist. The Director of Gastroenterology at Fortis Hospital in Mulund Mumbai has than 30 years of experience. This Director is known for using ultrasound, a technique that combines a scope with ultrasound to examine the pancreas, bile ducts and the walls of the gut in detail. Fortis Hospital offers care for a range of conditions including bowel syndrome, inflammatory bowel disease, celiac disease, gastritis, ulcers, liver disease, acid reflux and pancreatic problems. I find that the advice given for IBS is an example of the root-cause approach focusing on diet and stress much as on medicines.
Dr. Surendra Jasti, Robotic Gastro Surgeon . He has a Masters degree and a Doctorate degree in gastroenterology. He works at Crest Hospital in Vijayawada. His work focuses on laparoscopic and robotic surgery for gallbladder disease, hernia, appendicitis, colorectal problems and weight-loss (bariatric) surgery. He is, on the side of the divide: when a problem requires an operation this is the kind of doctor who does it.
Which one do you start with?
This is a rough guide only. A family doctor can help you decide.
| Problem | Usually starts with | Surgery comes in when |
| Acid reflux | Gastroenterologist: lifestyle changes, medicines, sometimes an endoscopy | Symptoms persist despite treatment, or a large hiatus hernia is found |
| Irritable bowel syndrome | Gastroenterologist: diet, stress management, medicines | Almost never |
| Crohn’s disease or ulcerative colitis | Gastroenterologist | Complications develop, or medicines can’t control the disease |
| Gallstones | Ultrasound, then often a surgeon | Stones cause repeated pain or complications; the gallbladder is removed |
| Hernia | Surgeon | Most eventually need repair; urgent if hard, painful or stuck |
| Fatty liver | Gastroenterologist: weight, diet, blood sugar | Occasionally, when weight-loss surgery is the best route to losing weight |
| Severe obesity | Medical weight management first | Bariatric surgery when criteria are met and other efforts haven’t worked |
A word about robotic surgery
Robotic surgery and laparoscopic surgery both use cuts and a camera. They usually cause pain and a quicker return to life compared to open surgery. A robot is simply a tool. It does not guarantee results. In operations robotic surgery and regular keyhole surgery produce outcomes. The surgeon’s experience with that operation matters more, than the machine. It is okay to ask how times the surgeon has performed that procedure.
Questions worth asking at the appointment
What do you think is causing this problem and what steps can we take to check it?
Are there ways to handle this without surgery and what could happen if I wait?
How many of these treatments do you perform every year?
What will the healing process be like? When should I get in touch with you?
If I have weight-loss surgery how will my health be watched over after that?
Getting another view before a big operation is common and a good doctor will not be upset about it.
Warning signs not to sit on
If you see blood in your stool I recommend you see a doctor soon. If you notice changes in your stool I recommend you see a doctor soon. If you have trouble swallowing I recommend you see a doctor soon. If you have vomiting that does not stop I recommend you see a doctor soon. If you have skin or yellow eyes I recommend you see a doctor soon. If you have weight loss I recommend you see a doctor soon. If you have pain that wakes you at night I recommend you see a doctor soon. A hernia that suddenly becomes hard and painful or that cannot be pushed back requires emergency care. Screening colonoscopy normally starts between the ages of forty‑five and fifty. It starts earlier if you have a family history of bowel cancer. So ask your doctor what schedule is best for you.
In short
Digestive problems are rarely solved by guessing. Digestive problems require a cause to be identified and then a decision must be made whether medicine, a procedure or an operation is the correct solution. Knowing which type of doctor to see first saves time. It makes it easier to ask the right questions once you are, in the room.
Disclaimer: This article is for general informational purposes only and does not constitute medical advice or a recommendation of any specific doctor or hospital. The information about Dr. Vipulroy Rathod and Dr. Surendra Jasti is drawn from the doctors’ own websites and has not been independently verified; it is not an endorsement. Digestive symptoms can have many causes, and the right specialist depends on the individual case. Readers should consult a qualified physician or family doctor for diagnosis and referral, and seek urgent medical care for warning signs such as blood in the stool, persistent vomiting, difficulty swallowing, yellowing of the skin or eyes, unexplained weight loss, or a hernia that becomes hard, painful, or cannot be pushed back. Screening schedules vary and should be confirmed with a doctor. The author and publisher disclaim any liability for decisions made based on this content.
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