Digestive problems and illnesses can manifest due to the lack of a healthy and nutritious diet and an imbalance in macronutrient intake. Gastroenterologists and proctologists have overlapping and interrelated areas of expertise in this field. As such, people often get confused about which specialist to see for their digestive problem.
Gastroenterologists are specialists in internal medicine related to the normal functioning of the digestive tract. They diagnose and treat diseases of the digestive tract that require medication and monitoring. Proctologists, on the other hand, are specialists in surgery of serious diseases related to the colon, rectum, and anal canal.
This article will show the difference between gastroenterologists and proctologists, particularly in terms of diagnostic procedures, types of diseases they treat, and the treatment procedures they perform.
What is a Gastroenterologist?
Gastroenterologists are the experts in the physiology of the digestive organs and the normal function of the digestive tract. They specialize in assessing the movement of food and liquid in the stomach and intestines and in determining any irregularities in digestion and absorption of nutrients.
They also diagnose people who have problems with their bowel movement as well as other related organs including the liver, pancreas, gallbladder, and the bile ducts.
They are trained in using scopes to check the condition of the digestive tract and diagnose digestive illnesses. They also provide a prescription for medication and additional assistive support and monitoring for any complication during the treatment.
Gastroenterologists diagnose illnesses through various procedures. Some of the most common diagnostic procedures for gastroenterologists are endoscopy and colonoscopy.
Endoscopy involves inserting a flexible, narrow tube equipped with a light and a camera called the endoscope into the throat to determine the condition of the digestive tract, from the esophagus to the duodenum or the entrance to the small intestine. The colonoscopy, on the other hand, involves inserting a tube scope called a colonoscope into the rectum to determine the condition of the colon.
Proctoscopy is also another diagnostic method where-in the doctor inserts the proctoscope or a small and hollow metal tube with a small light bulb to check the condition of the anal cavity and the sigmoid colon or the end part of the colon that leads to the rectum.
Gastroenterologists can also use capsule endoscopy for a more in-depth inspection of the digestive tract, particularly inside the small intestine. This is an effective method for inspecting the small intestine since traditional endoscopy is unable to go beyond the duodenum.
The capsule endoscopy works by swallowing a pill camera, or a camera enclosed within a vitamin-sized pill that takes thousands of images of the digestive tract and transmits the images through a device worn around the waist.
Gastroenterologists also conduct other imaging procedures including ultrasound, MRI, CT scans, and x-rays depending on the symptoms. Other diagnostic procedures that gastroenterologists conduct are gastroscopy, endoscopic ultrasounds, double-balloon enteroscopy, and sigmoidoscopies.
They can also perform liver biopsies to diagnose fibrosis or liver inflammation. Depending on the severity of the disease, the gastroenterologist can prescribe medication or refer the individual to a proctologist to determine if surgery is necessary.
Types of Diseases
Gastroenterologists specialize in providing medication for people suffering from digestive illnesses as well as more serious diseases like polyps, cancer, and ulcer. One of the most common conditions that gastroenterologists treat is heartburn or irritation of the lining of the esophagus caused by the burning sensation that occurs when acid from the stomach goes up the esophagus.
Frequent heartburn caused by acid reflux can be a sign of a more serious disease called gastroesophageal reflux disease or GERD. This disease is more common for people who are overweight or heavy smokers.
Gastroenterologists can also provide medication for inflammatory bowel disease, colon polyps, peptic ulcer, and hepatitis. They can also provide medication for people suffering from Celiac Disease or the disease where the immune system attacks and damages the small intestine when it detects gluten in the system. They conduct a biopsy to extract a small part of the small intestine to determine the extent of the damage and provide treatment recommendations.
Aside from serious illnesses, gastroenterologists can also help people with lactose intolerance. They can prescribe supplements like lactase enzymes that can help in digesting lactose. They can also provide advice for dietary changes that can help relieve symptoms of lactose intolerance.
Gastroenterologists provide treatment through non-surgical methods. They can perform some invasive procedures for a diagnosis like an endoscopy and colonoscopy. They can also perform invasive treatment procedures like esophageal dilation to lengthen the esophagus to relieve difficulty in swallowing caused by scarring of the esophageal lining due to GERD or excess tissue.
However, gastroenterologists do not and are not trained to perform surgery. They specialize in providing daily assistance and monitoring for patients in addressing symptoms and managing the side effects of medication and providing care on a long-term basis.
What is a Proctologist?
Proctologist is an outdated term that refers to doctors who diagnose and treat illnesses and disorders related to the anus and the rectum. Today, proctologists are called colon and rectal surgeons or Colorectal Surgeons.
Colorectal surgeons diagnose and treat chronic and acute diseases of the colon and rectum but are also trained in treating diseases of the digestive tract up to the anal and peri-anal area.
Colorectal surgeons start as general surgeons who perform surgery on all areas of the GI tract. Thus, they have similar training and expertise in conducting diagnostic procedures as gastroenterologists such as endoscopy and colonoscopy. For serious conditions of the rectum up to the colon, however, colorectal surgeons are the specialists for performing surgery.
Colorectal surgeons perform more specific diagnostic tests than gastroenterologists due to their specialization in the colon and rectum area. They perform a wide range of diagnostic procedures that may or may not require the use of equipment.
The Digital Rectal Exam (DRE) is the basic diagnostic procedure for colorectal surgeons for examining the rectum and other organs, including the prostate. This procedure involves inserting a gloved finger with lubrication in the anus and into the rectum to feel any bumps and spots as signs of abnormalities.
The anoscopy is another diagnostic procedure that involves using the anoscope, a tubular instrument made of disposable plastic or sterilizable steel, which allows the doctor to check the tissue in the anal canal and rectum. The proctoscopy and sigmoidoscopy are similar diagnostic procedures for examining tissue for abnormality.
The barium enema and the endorectal ultrasound are both imaging tests to determine abnormalities in the colon and rectum, respectively. Usually, colorectal surgeons perform imaging tests to determine any cancerous mass in the colorectal region.
Types of Diseases
Colorectal surgeons can treat serious cases of hemorrhoids, especially in cases where the veins inside or outside the anus are severely swollen and cannot be treated quickly with oral and topical medication. They can also operate on anal fissures or tear in the anal canal that can lead to infections known as abscess and fistulae. They can also remove anal skin tags or lumps around the surface of the anus.
Colorectal surgeons can also remove polyps or non-cancerous or pre-cancerous mass as well as other kinds of masses like diverticulitis which occurs in the lining of the digestive tract. They can also treat several types of inflammatory bowel diseases such as ulcerative colitis and Crohn’s Disease.
Furthermore, they can also treat sexually transmitted diseases (STDs) including chlamydia, gonorrhea, syphilis, and herpes.
Polypectomy is the main procedure for removing polyps in the lining of the colon and rectum. This involves using wire loop forceps or electric current to burn and remove the pre-cancerous mass.
Other surgeries that colorectal surgeons perform are bowel obstruction repair or removing obstruction in the bowel area; colectomy or repair of the colon; colostomy or the diversion of the stool to exit through the abdomen; and colonoscopy with polypectomy or colon examination and removal of existing polyps.
Colorectal surgeons can also perform microsurgeries which involve making small incisions under a laparoscope. The pelvic laparoscopy is an example of microsurgery which is performed when repairing or removing tissue in the colon. It can also be used to repair or remove parts of the urinary tract as well as the ovaries and uterus.
When to See a Gastroenterologist or Proctologist?
It is best to see a gastroenterologist for problems related to the gut or gastrointestinal tract. Symptoms of gut problems include stomach pain, heartburn, difficulty in swallowing, and yellowing of the skin. Serious symptoms can include rectal bleeding and frequent abdominal pains.
Conversely, it is best to seek a colorectal surgeon for problems related specifically to the colon and rectum. Symptoms of colon or rectal diseases include anal itching or pain, with serious cases accompanied by bleeding or pus discharge. Cases of anal warts and fecal incontinence are also urgent cases that must be consulted with a colorectal surgeon immediately.
Usually, it is not imperative to go directly to a colorectal surgeon for examination and diagnosis because gastroenterologists and colorectal surgeons often work closely. These two professions work together to provide surgical and non-surgical treatment.
Gastroenterology is a section of internal medicine while proctology is a section of general surgery. Thus, these two fields naturally go hand-in-hand during the treatment of digestive conditions.
Gastroenterologists and proctologist, or colorectal surgeons, have similarities in their specialty in the human anatomy. However, they have distinct differences in the diagnostic procedures, types of diseases they treat, and treatment methods they employ. Proctologists are more specific and narrow in terms of the treatment procedure and are often more reserved for serious cases that require surgery.