30 Secrets Gastroenterologists Will Never Tell You


Yes, they deal with people’s poop on a daily basis and want to
help you with diarrhea.

Posted on March 25, 2017, 15:01 GMT

Gastroenterologists are physicians dedicated to treating
and managing diseases of the gastrointestinal tract (GI
tract) and liver. Basically, they’re who you go to when
you’re experiencing major stomach, bowel, or intestinal
issues. BuzzFeed Health reached out to some
gastroenterologists to tell us more about this huge and
intriguing area of expertise. Special thanks to the
gastroenterologists who provided intel and anecdotes for this
post: Dr. Sahil Khanna, gastroenterologist with
Mayo Clinic, and Dr. Rebekah Gross, gastroenterologist
with NYU Langone.

1. Yes, we want to know EXACTLY what
your poop looks like — and the more details the

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As gastroenterologists, we are interested in patients’
bowel habits, what their stools look like (if there’s
blood in it, for example), if there’s pain in their
bellies or pain in their bowel movements, etc.

2. Your emotions can play a huge part
in why your stomach and bathroom routine are all messed

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Stress, anxiety, and depression cause a lot of the
symptoms patients come in to see us about. Sometimes your
emotions lead you to eat differently, sometimes they mess
with your sleeping schedule, and sometimes they create
physiological changes in your body (higher blood
pressure, for example) that can mess with your digestive

3. That’s why GI and psychiatry overlap
a lot, and most times we end up forming close, life-long
relationships with our patients.

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Gastroenterologists have a real opportunity to make a
relationship with the patient. Digestive issues can be a
sensitive subject and sometimes you really have to get a
patient to warm up to you and trust you before they’ll
tell you what’s really going on.

4. Most people come in to see us when
they have issues with diarrhea and/or constipation.

5. We want you to know that getting
bloated, gassy, and having diarrhea is going to happen
sometimes and that’s totally normal.

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Guys, it’s normal for your digestive system to make some
noise. People come in to see us because they don’t want
to feel bloated, or fart, or have loose stools, but
sometimes these things are just going to happen. People
want a cure for everything, but there isn’t always one.

It’s great that people are bringing it up and more
comfortable talking about it. But sometimes you just have
to deal with things like that. Although, we will say if
you’re experiencing new symptoms, or you’re experiencing
chronic symptoms over a long period of time you should
come in and see us.

6. A regular workday for us usually
includes vomit, constipation, bloody poop, bad breath, gas,
and hemorrhoids. So there’s really not much that phases

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In the clinic, we sometimes see 12 to14 patients a day.
So trust us when we say we’re comfortable doing this and
that you should never be embarrassed to tell us something
— seeing poop and talking about diarrhea is just another
day at work for us.

We’re also patients. We get colonoscopies and take the
same procedure prep as you, so we know what you’re

7. We might need to do a rectal exam
during checkups, and that means putting our finger up your

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The physical exams that we do are not painful, but they
are slightly uncomfortable. We will sometimes use
lubricant jelly to make it easier for patients. We do
this day in and day out for patients, so please don’t
feel embarrassed or ever think that we’re judging you.

8. And actually, this test is
incredibly important because it can answer things that a CT
scan cannot.

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Some patients with constipation can’t empty their bowels
because of pelvic floor dysfunctions, which means their
muscles aren’t relaxing and allowing them to poop. So
we’ll have to put our finger up their rectums and ask
them to squeeze and loosen to make sure the muscles are
working properly — a CT scan won’t show us that.

9. When people come in with symptoms
that hint at bowel inflammation, we’re usually looking for
things like Crohn’s disease or ulcerative colitis.

Encrovision / Via Getty Images

Sometimes we also diagnose celiac disease.

10. We don’t do surgeries, but we do
perform procedures like colonoscopies and upper endoscopies
so we can check out your digestive system.

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Gastroenterologists don’t do incisions or surgical
removals and repairs within the gastrointestinal tracts.
We primarily do procedures called upper endoscopies —
examining the esophagus, stomach, and small intestines by
way of the mouth — and colonoscopies, where we examine
the lining of the large intestine, colon, and rectum by
way of the butt.

11. And those entail sticking a long
flexible tube with a light and camera, called a scope, either
down your throat or up your butt.

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The scope projects an image onto a TV screen, which we
watch as we move it through the upper or lower GI tracts,
depending on the procedure we’re doing. We use dials and
knobs on the scope to advance it up or down the tract and
can also attach tools to the scope in case we need to do
a biopsy, which involves removing a bit of tissue and
examining it to determine the presence, cause, or extent
of a disease.

12. We’ve also used scopes to remove
lots of random objects from people’s stomachs and butts, such
as forks, batteries, and gloves.

13. You’ll have to ~prep~ for a
colonoscopy, which means taking a laxative, or something
similar, so that there’s no poop backed up in your system.
This lets the scope roam your colon freely.

NBC / Via tenor.co

To prep for a colonoscopy, you usually have to drink only
clear liquids for at least 24 hours before the procedure
and take a laxative or cleansing solution, ordered by the
physician, to clear out all the stool so that your
intestines can be seen.

For an upper endoscopy, you’re usually not allowed any
food or drinks for six hours before the procedure because
being on an empty stomach will allow the GI to have the
best view of your upper GI tract and carry out the safest

14. From mouth to anus, it’s actually
one long continuous tube with natural twists and

Foottoo / Via Getty Images

15. Wielding that scope through the anus
and the rest of the digestive tract can be hard work; many
GIs even end up with muscle pain and arthritis symptoms
earlier in life because of it.

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Procedures can be exhausting. You’re on your feet all
day, wielding a scope, and using the dials to move it
back and forth, all while turning your head awkwardly to
see the screen, which really hurts your neck. There’s
also a lot of fine motor work that goes into working the
dials on the scope. So one hand is always operating the
dials, while the other is pushing the scope through the

16. Some people have ~tortuous colons~,
which can be harder to navigate for GIs.

Everyone’s colons take twists and turns, but some people
have longer colons than others (also known as a “tortuous
colon”), which can be hard to navigate because you have to
do a lot of special maneuvers to get the scope through

Some people have also gotten colorectal surgery and have
scar tissue so that can make the colon harder to navigate
as well.

17. Polyps can grow on the lining of the
colon and need to be removed during colonoscopies in case
they become cancerous.

Eraxion / Via Getty Images

Polyps are small clumps of cells that form on the colon
and usually need to be removed around the time you’re 50.
There are tools that GIs can attach to a scope so that
the polyps can be taken out during a colonoscopy. Some
polyps can develop into colon cancer, which can be fatal
if they aren’t caught early on.

Sometimes a polyp will be too big, or on an area of the
colon that’s too risky to remove by colonoscopy. So we
will have to plan for you to see a colorectal surgeon to
get it taken out. If you routinely see a doctor at the
recommended age (more on this soon), you can likely
prevent colon cancer and avoid surgery.

18. Rectal bleeding, unexplained weight
loss, and bowel movements that disrupt your sleep are
definitely signs that you should see a

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You can have diarrhea all day long, but a sign that it’s
much more serious is if your bowel movements are breaking
through your sleep and waking you up. You should come in
for these symptoms sooner, rather than later.

19. But just because you may not have
“symptoms,” that doesn’t mean you’re free of polyps, lumps,
or abnormalities that could potentially become

Amarand Agasi / Creative Commons / Via Flickr: theamarand

You could be completely regular with your bowel movements
and have no issues with your digestive tract, but still
have polyps and lumps and abnormalities that could be or
potentially become cancerous. If you don’t have a family
history of colon problems, you probably won’t develop
these until mid-life. However, rates of colon cancer among young people
are rising.

20. That’s why anyone over the age of
50, and anyone younger with a family history of colon
problems, should get a colonoscopy.

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People with an average risk should start getting screened
for colon cancer (which will likely include a
colonoscopy) starting at age 50. If you have a family
history of colon problems or you have any new GI symptoms
(like a change in bowel habits, bleeding, abdominal
pain), you should be screened before then.

Here are the complete recommendations for colon cancer
screening depending on your unique risk factors.

21. Yes, you can still get a colonoscopy
done while on your period.

FOX / Via tenor.co

We have to remind people that we go through your rectum
with the scope, and that’s a completely different hole
from where the blood is coming out.

22. One of the most emotional parts of
the job is when people come in with colon cancer, because
it’s often preventable with regular screenings.

VH1 / Via giphy.com

Please, never let embarrassment keep you from
coming to the doctor’s office. Even if we don’t make a
diagnosis, we can give you some tips to minimize your
symptoms and get you educated on what’s going on inside
your body. There’s nothing you can come in with that we
haven’t seen and can’t help you with.

Colon cancer is incredibly preventable if you catch it at
the right time. But if you come in too late and the
cancer is in its later stages, there is a high chance
that it will be fatal.

23. Please don’t self-diagnose yourself
with celiac disease or gluten intolerance and go off of
gluten before coming to see us. That will only make it
harder for us to help you.

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When people self-diagnose and cut gluten (or anything
else) from their diets, we have to put them back on it in
order to see their body’s response to it and diagnose and
treat what’s going on. Even if you have the disease, it’s
hard to test positive for celiac disease if there’s no
gluten in your diet. And it’s already hard to distinguish
between people who have celiac and people who just have a
hard time digesting gluten.

Either way, come to us before you make any drastic
changes to your diet so that we can establish a baseline
and follow your progress.

24. Also, prescribing your own treatment
(after self-diagnosing) can be dangerous and delay the help
that could potentially save your life.

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There are certain diagnoses you obviously don’t want to
delay. You don’t want to be treating yourself for the
wrong thing and then find out months later you actually
have something else and now it’s much more serious than
it would’ve been if you had gotten checked out sooner.

Most of us went through undergraduate school, four years
of medical school, three years of residency, and three
years of fellowship (and some even take an extra year to
focus on procedures or treating IBS), so please let us do
the diagnosing.

25. To keep a healthy digestive tract,
eat a high-fiber diet with lots of fruits and vegetables,
make sure you drink a lot of water, and please, please stop

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Staying hydrated will help you help flush out your system
and keep everything moving smoothly, while eating a high
fiber diet with nutrient-dense fruits and vegetables can
keep your bowel movements regular. Who doesn’t want that?

26. And please, please stop smoking

NBC / Via popkey.co

Smoking has been tied to an increased risk of peptic
ulcers, heartburn, gallstones, Crohn’s disease, liver
disease, gastroesophageal reflux disease (GERD), and
other common disorders in the digestive system. Just

27. Yes, we sometimes get GI-related
emergency calls in the middle of the night.

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Patients can’t help when they experience serious rectal
bleeding, rectal or abdominal pain, fevers, stool
leakage, etc., so we give out our phone numbers and are
almost always on call just in case someone needs to see

28. Sometimes we have to complete
47-hour shifts and then drive home, sleep a little, and be
ready to do it all again.

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Emergency situations are just added to what you already
have on your schedule for the day. So if we get a phone
call in the middle of the night, we’ll go to the
hospital, work till the morning, and then go straight to
all our client meetings in the morning.

29. Ever wonder why someone would go
into gastroenterology? To put it simply, we want to help
people with everything from poop troubles to cancer.

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Many of us got into the field to potentially save
someone’s life from colon cancer or help people who
suffer from debilitating conditions like inflammatory
bowel disease.

30. Overall, if you’re experiencing GI
symptoms, it’s ALWAYS better to be cautious and just make an

Universal Pictures / Via youtube.com

The GI track is really complicated. So if you’re having
acute symptoms that came on suddenly out of the blue,
you’re having trouble eating, or if you’ve been having
chronic symptoms with relative frequency, it’d be safer
to come in and get checked out. You don’t want to miss
out on a more serious diagnosis, so always err on the
side of seeing a gastroenterologist.

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