When it comes to your digestive health and issues, there are a few medical specialists you can turn to that play a vital part in treating and diagnosing conditions that affect the gastrointestinal system. The most common specialists you will come across are gastroenterologists and proctologists, also called colorectal surgeons.
While both focus on the digestive system and disorders, when it comes to a proctologist vs gastroenterologist, each one has a range of unique areas of expertise. Knowing which professional to see for which digestive ailment is important to get the best care and treatment for your digestive health issues.
Proctologist vs Gastroenterologist: What’s the Difference?
Proctologists, or colorectal surgeons, are specialists in diseases of the colon, rectum and anus. They are surgical specialists who have trained 5 years in general surgery and then complete a 1 year fellowship in colorectal surgery/proctology. Proctologists have specialized surgical knowledge in conditions such as small and large bowel disease like:
- Ulcerative Colitis and Crohn’s
- Small bowel obstruction
- Diverticulitis
- Hemorrhoids
- Anal fissures
- Anal abscess
- Anal fistula
- Anal warts
- HIV anal ulcers
- Anal dysplasia
- Colon, rectal and anal cancers
Though trained to be surgeons they can treat conditions both non-surgically and surgically.
Gastroenterologists, on the other hand, are internal medical doctors who after a 4 year residency in internal medicine complete a 1 – 2 year fellowship in gastroenterology. They study the medical aspect of the whole gastrointestinal tract which includes the esophagus, stomach, small intestine, colon, liver, gallbladder, and pancreas. They medically treat conditions like Inflammatory bowel disease (Crohn’s and Ulcerative Colitis) IBS, acid reflux, gastritis, liver diseases, and more.
To diagnose or treat conditions, gastroenterologists use a large array of tools including endoscopy, capsule endoscopy, imagining studies, and medications to provide care for patients.
As you can see, proctologists and gastroenterologists have similar areas of interest. Both perform colonoscopies, both see patients for bleeding, itching, hemorrhoids etc. Beyond the upper and lower GI endoscopy, the gastroenterologists leave the surgical and other less invasive treatments of the disease to the proctologists.
The gastroenterologist typically does not perform hemorrhoid procedures though some do banding of hemorrhoids in the office or at the time of the colonoscopy. Gastroenterologists are doctors which mainly prescribe medical therapy for Crohn’s, Ulcerative Colitis, IBS, H. Pylori, hemorrhoids, itching, fissures, etc.
Once these therapies fail and further therapy is needed the patient is referred to the colorectal surgeon/proctologist. The colorectal surgeon/proctologist will also prescribe medications for hemorrhoids, itching, anal fissure etc., but most don’t prescribe medication for Ulcerative Colitis and Crohn’s disease, they leave this for the gastroenterologists.
What Does a Proctologist Treat?
If you are experiencing problems in the rectum, anus, or surrounding area, a proctologist is the doctor to see. They specialize in the diagnosis and treatment of the rectal and anal areas. They can also provide surgical and non-surgical treatments.
Some common conditions that they treat are
- Hemorrhoids
- Anal fissures
- Anal fistulas
- Anal warts
- Rectal prolapse
- Anal cancer
- Rectal polyps
- Anal dysplasia
- Inflammatory bowel disease
- Colon and rectal cancer
- Small bowel obstruction
- Diverticulitis requiring surgery
- Rectal prolapse
Treatments and Surgeries Proctologists Perform
The biggest difference between a proctologist vs gastroenterologist is that a colorectal surgeon/proctologist are surgical specialists. A proctologist is a colorectal surgeon who focuses primarily on the colon, rectum and anus with colonoscopy and does minor surgery not major abdominal surgery.
Surgeries performed by colorectal surgeons include, but by no means limited to:
- Rectal prolapse surgery
- Anal sphincter repair
- Anal cancer surgery
- Anal sphincter repair
- Anal fistula surgery
- Anal stenosis surgery
- Anal fissure surgery
- Fissurectomy
- Hemorrhoidectomy
- Wart excision
- Partial colectomy
- Subtotal colectomy
- Total abdominal colectomy with proctectomy and small bowel pouch (Ulcerative Colitis)
- Small bowel resection for Crohn’s disease
- Small bowel sphincteroplasty for Crohn’s disease
These are only a few examples of the surgical procedures that a proctologist can perform. A proctologist will work closely with a patient to determine what type of treatment is needed for their condition.
What Does a Gastroenterologist Treat?
Gastroenterologists focus on conditions that affect the whole digestive system. This means they have the expertise to diagnose and treat conditions in the stomach, small intestine, colon, liver, and more.
Among some of the condition gastroenterologists treat are:
- Peptic ulcer disease
- H. Pylori
- Irritable bowel syndrome
- Gastrointestinal cancers
- Gallbladder and biliary tract disorders such as gallstone removal and stenting of the biliary tract.
- Liver disease
- Pancreatic disorders
- Gastroesophageal reflux disease (GERD)
Proctologist vs Gastroenterologist: Which Type of Doctor Do You Need?
Which doctor you need to see, a proctologist vs. gastroenterologist, will be determined by your symptoms and primary care provider, who can help determine which route to start with.
If you are experiencing symptoms that are primarily related to the rectum, anus, or lower gastrointestinal tract, you will more than likely need to see a proctologist. For example, if you have anal pain, bright red bleeding, an anal lump(s), hemorrhoids, anal itching, incontinence of stool or gas, low abdominal pain, rectal prolapse, anal fistula, anal abscess, or anal warts, a proctologist can help you treat those conditions.
However, if you have pain that is more located in the stomach region or higher, a gastroenterologist should be your first stop. They can help with symptoms from acid reflux, IBS, celiac disease, and more. In some cases, you may require care from both specialists or a referral from one to the other for a full evaluation.
Depending on the condition and treatment, you may need surgery, in which a proctologist is trained to do so. To know which doctor will be able to help treat your conditions, speak to a primary care physician who can evaluate your symptoms and direct you to the care you need.