Short Answer: Gastroenterologist or Colorectal surgeon or even a primary care doctor can perform a colonoscopy. However, due to the sheer volume of endoscopies performed by a gastroenterologist on a daily basis, a highly experienced gastroenterologist is the most preferred and effective option.
Colonoscopy: The colonoscopy procedures allows the doctor/nurse to look inside a patient’s intestine/colon or rectum. During this procedure a lighted, flexible tube with a camera at the end (colonoscope) is inserted into the patient’s intestine/colon or rectum. The camera on the tube allows the doctor/nurse to look at the intestinal/colon/rectum linings or the bowels. A biopsy can also be performed during a colonoscopy.
The procedure itself may only take an hour and does not cause much pain. However, expect to spend up to 3 hours for waiting, preparation and recovery.
Gastroenterologist: Gastroenterologists are trained in general internal medicine and also undergoes additional training in gastroenterology and scoping procedures. A gastroenterologist diagnoses and treats conditions of the digestive tract affecting esophagus, stomach, gall bladder, pancreas, liver, small and large intestine, rectum and the ducts between these organs.
It is recommended to see a gastroenterologist if you have any of these gastrointestinal (GI) symptoms – Abdominal pain, gas, constipation/diarrhea, blood in stool, bowel changes, indigestion, heartburn, liver diseases, rectal itching, rectal bleeding, nausea, Colon polyps, GERD, Celiac disease, colon cancer screening, hemorrhoids, intestinal tract infections, Irritable bowel syndrome, lactose intolerance, inflammatory bowel disease, pancreas disease, ulcers of the intestinal tract, peptic ulcers etc.
A gastroenterologist diagnoses and treats GI issues. They can even perform minimally invasive procedures for patients with hemorrhoids. In case a surgery is required to treat a condition, they refer the patient to colon and rectal surgeons (Proctologist).
Why we say Gastroenterologists are the best option
- Their qualification: The American Society for Gastrointestinal Endoscopy (for gastroenterologists) requires physicians to complete 200 colonoscopies before they will assess their competency and most fellows complete at least 500 colonoscopies during their three year training programs. Whereas, the American board of Surgery (for surgeons) mandates only 50 colonoscopies to be completed by the surgical residents during their five year training.
- Their experience: On average Gastroenterologists perform much more colonoscopy procedures than a surgeon or a primary care doctor. This wealth of experience will definitely play a critical role in effective screening.
- Study comparing Gastroenterologists, Primary care physicians and Surgeons: There are studies that have observed that colonoscopies done by Gastroenterologists have resulted in 65% lesser occurrences of colon cancer death compared to 57% and 45% when performed by a primary care doctor or a surgeon. 1 Note that this does not prove anything regarding the effectiveness of the doctors/role involved. The numbers may be due to the fact that people go to surgeons in a later stage of the disease and hence the reason for higher death rates. Nevertheless, it is a published study and we wanted to share the same.
Note that there are always exceptions and there may be many gastroenterologists that may not be good at their job and there may be a lot of surgeons and primary doctors who are exceptional in colonoscopy screening. But the point is very clear, if you are in need of a colonoscopy screening… do not delay the screening just because a gastroenterologist is not available. A colonoscopy performed by a surgeon/primary care doctor is better than not doing a colonoscopy at all!
Choosing the best Gastroenterologist
- Find a board certified gastroenterologist at American college of Gastroenterology website.
- Read these tips to understand how to choose the best gastroenterologist.
Baxter N, Warren J, Barrett M, Stukel T, Doria-Rose V. Association Between Colonoscopy and Colorectal Cancer Mortality in a US Cohort According to Site of Cancer and Colonoscopist Specialty. Journal of Clinical Oncology. 2012;30(21):2664-2669. doi:10.1200/jco.2011.40.4772.↩