Do You Need A Colorectal Surgeon or Gastroenterologist?

Understand which specialist you need for Crohn's or ulcerative colitis

People with inflammatory bowel disease (IBD) may, at times, be unsure which specialist to call for advice or direction about their Crohn's disease or ulcerative colitis. If the problem has to do with recent surgery, the colorectal surgeon may be the better specialist to call. This is especially true if a surgical site is not healing the way it should, or if there is an unexpected pain.

For questions about regular medications, vaccinations, or a new problem that might be related to IBD (such as pains in the joints, skin problems, or eye problems), the gastroenterologist would be the specialist to contact. 

Some people with IBD see their colorectal surgeons more often than they do their gastroenterologist and the reverse is also true. There are several aspects to consider when it comes to which specialist may be needed. Another point to consider is the relationship a patient has with each physician and from which specialist it will be easier to get in to see and receive the care that's needed. This article will describe more about colorectal surgeons and gastroenterologists and their training, which may help people who live with IBD to understand which aspects of IBD might be more appropriate for one or the other specialty.

Surgeons operating
Tim Pannell / Corbis / VCG / Getty Images

Why People With IBD May Need A Colorectal Surgeon

People with IBD may see a colorectal surgeon from time to time. One reason for this is if a gastroenterologist calls for a surgical consult: this could be to determine if the Crohn's disease or ulcerative colitis are at a point where the disease would be better managed through surgery. The gastroenterologist should also be kept in the loop as to what next steps are, in order to better coordinate medical therapy before, during, and after any surgery.

A colorectal surgeon may not always advise that surgery is the best course of action. Sometimes a surgeon is consulted to give a patient and their family more options or to help determine if it might be better to wait for surgery. If you are sent by a gastroenterologist to talk to a colorectal surgeon, it doesn't always mean that you are headed for surgery.

After surgery, people with IBD may keep in contact with the colorectal surgeon for some time, especially if the surgery was for ostomy or j-pouch surgery. This is because if there is a question about recovery or complications such as abscess, fistula, ileus, intestinal blockages, or adhesions, the colorectal surgeon may be in a position to help.

Why People With IBD Need A Gastroenterologist

Gastroenterologists are the physicians who will coordinate most of the care for managing IBD. For the most part, IBD is managed with medications and it is necessary to have a specialist make recommendations on these treatments. Some gastroenterologists specialize in IBD and are found at IBD centers. However, all gastroenterologists receiving training in caring for patients with IBD. For day-to-day concerns about IBD, including managing symptoms (such as diarrhea, bloody stools, constipation, or pain), addressing medication side effects, or coordinating care or referrals for extra-intestinal manifestations (which may include skin, eye, or join problems), a gastroenterologist will be the primary point of contact.

Procedures and Tests

When it comes time to have a colonoscopy or other endoscopic procedure, either a colorectal surgeon or a gastroenterologist may be able to complete the test. Which doctor conducts the procedure will be based on that physician's expertise and their knowledge of your particular disease and medical history, as well as availability and insurance considerations. Some people with IBD have one physician who often does endoscopy procedures, and another physician who coordinates all the medical care (such as prescriptions, referrals, and ordering lab tests).

Some colorectal surgeons will have specialized knowledge of patients with IBD and have more experience with common IBD surgeries such as resections, ostomies, j-pouches, and strictureplasty. 

A Third Option: Enterostomal Therapy Nurse

An enterostomal therapy (ET) nurse is a specialized type of healthcare provider who helps with the care of ostomy (ileostomy or colostomy). An ET nurse has training in assisting patients with their needs before, during, and after ostomy surgery. For those with IBD who live with a stoma, when there are questions about peristomal skin, ostomy appliances, or other ostomy concerns, an ET nurse may be the first point of contact.

Colorectal Surgeons

A colorectal surgeon has a particular interest in diseases of the colon and rectum. To become proficient in the treatment and management of these digestive conditions, a colorectal surgeon must undergo training in both general surgeries as well as advanced training in the problems of the lower digestive tract. A colorectal surgeon might also sometimes be called a proctologist.

A general surgery residency program generally includes 5 to 6 years of training after the completion of a four-year medical school program. Specialized programs that a general surgeon must undergo to become a colon and rectal surgeon generally take one to two more years. In all, a colorectal surgeon has undergone a minimum of 14 years of formal classroom education and practical training before becoming licensed to practice medicine as a colorectal surgeon.


In order to become a licensed, board-certified gastroenterologist, physicians must complete 13 years of education and practical training. A gastroenterologist fellowship, which is 3 years long, is where a physician receives training in the diagnosis, management, and treatment of diseases and conditions of the gastrointestinal tract. Another year is necessary if a gastroenterologist decides to pursue training in hepatology, which is the study of liver diseases.

The societies that oversee fellowship training for gastroenterologists are the American Board of Internal Medicine (ABIM), the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), and the American Society for Gastrointestinal Endoscopy (ASGE). After completing fellowship training, a gastroenterologist becomes board certified by passing an exam given by the ABIM.

Locate a Colorectal Surgeon

Finding a colorectal surgeon can be tricky in some areas of the country. You can use the American Society of Colon and Rectal Surgeons and Canadian Society of Colon and Rectal Surgeons resources to help find a specialist physician that is working in your area.

Locate a Gastoenterologist

The ACG provides an online locator to find local gastroenterologists. A hepatologist can be found using the liver specialist locator. Patients can check on a physician's board certification through an online verification portal maintained by the American Board of Medical Specialties (ABSM).

A Word From Verywell

With IBD, it can be challenging to know which specialist might be needed, particularly if there are several that are on the care team. At times, the physician may be the one to suggest another specialist. For those who have a close relationship with an internist, family physician, or primary care physician, a quick check with that doctor may help in deciding which specialist to engage. In most cases, the gastroenterologist should probably be the first phone call or patient portal message to send unless it's clearly a surgical problem. In most cases, it's going to be the gastroenterologist that will coordinate the care of IBD and keep in touch with other specialists as needed.

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  2. Obias VJ. Pursuing fellowship training in colorectal surgery: a candidate's perspectiveClin Colon Rectal Surg. 2006;19(3):109–113. doi:10.1055/s-2006-948020