By Alicia Cowley, MD, MBA, Internist & Medical Director, Phreesia
As a hospitalist, I often saw patients when their digestive disorders had reached a crisis point—when stomach pain or gastrointestinal (GI) bleeding finally brought them to the emergency department. Many had been silently managing symptoms for months, or even years, without seeing a gastroenterologist. By the time they came to the hospital, the problem was no longer routine. It was advanced, and in some cases, avoidable.
Despite how common GI complaints are, many patients hesitate to ask for a referral to a specialist. They’re often told to “wait it out,” try a different diet or switch medications one more time. Sometimes, they don’t even know that seeing a gastroenterologist is an option or when it’s the right step. What starts as a mild or manageable issue can gradually progress, leading to more serious complications that disrupt daily life or land you in the hospital.
This post is a guide to help you recognize when it’s time to take your symptoms seriously, how to advocate for a referral and how to prepare for your first appointment with a gastroenterologist.
When to see a gastroenterologist for digestive symptoms
Primary care providers manage many GI issues well. But certain symptoms—and persistent digestive disorders—warrant specialty care. Here are key reasons to seek a GI referral:
1. Irritable bowel syndrome (IBS)
Irritable bowel syndrome causes recurring abdominal pain, bloating, constipation and/or diarrhea. It’s often underdiagnosed or self-managed for too long. If your symptoms are persistent despite dietary changes, stress management and first-line medications, a GI specialist can offer further testing and treatments tailored to your symptom subtype (IBS-C, IBS-D, or mixed).
2. Chronic heartburn or acid reflux (GERD)
Occasional heartburn is common. But if you’re relying on antacids more than twice a week, or if you experience symptoms like chronic cough, hoarseness or difficulty swallowing, a gastroenterologist can help treat gastroesophageal reflux disease (GERD) and rule out complications like esophagitis or Barrett’s esophagus.
3. Persistent abdominal pain, bloating or diarrhea
These can be signs of many conditions, from food intolerances and SIBO (small intestinal bacterial overgrowth) to inflammatory bowel diseases like Crohn’s or ulcerative colitis. A GI specialist can order specialized tests that go beyond what’s typically done in primary care.
4. Blood in stool or unexplained anemia
These are red flags that should never be ignored. A gastroenterologist can perform procedures like a colonoscopy to investigate and rule out more serious conditions, including colorectal cancer.
5. Constipation that doesn’t respond to lifestyle changes
If increasing fiber, hydration and exercise hasn’t made a difference, it’s time to explore other causes and treatments. Chronic constipation can be a sign of motility disorders or pelvic floor dysfunction—both best evaluated by a GI specialist.
How to ask for a referral to a GI specialist
If you’ve been managing GI symptoms without relief, it’s time to bring it up with your doctor. Here’s how:
- Be specific: Explain the frequency and impact of your symptoms—on sleep, work or meals.
- Share your history: Mention how long this has been going on and what you’ve already tried, including over-the-counter (OTC) remedies, dietary changes or prior prescriptions.
- Ask directly: Use clear language. Try saying, “I’d like to see a gastroenterologist to better understand what’s going on and what else might help.”
- Revisit the conversation: If your symptoms persist, don’t hesitate to bring it up again—or seek a second opinion.
Preparing for your GI appointment: A quick checklist
Once you’ve scheduled your appointment, here’s how to make the most of it:
- Track your symptoms: Keep a log of your stomach pain, bloating, bowel changes or reflux—what triggers it and when it happens.
- Bring a medication list: Include everything: prescriptions, OTC meds, antacids, probiotics and supplements.
- Know your family history: Share any family members with inflammatory bowel disease, celiac disease, colon polyps or cancer.
- Be honest about lifestyle details: Sleep, diet, stress, alcohol and exercise habits all influence gut health. Your doctor isn’t there to judge—just to help.
- Bring your questions: Writing them down ahead of time ensures you won’t forget in the moment. Here are some to get you started:
- What are the possible causes of my symptoms?
- Do I need testing like a colonoscopy or imaging?
- What are my treatment options, and when should I expect relief?
Find the right gastroenterologist for your needs
Not all GI specialists treat the same conditions. Some focus on liver disease or IBD; others specialize in women’s digestive health, motility issues or advanced endoscopic procedures.
That’s why using an online doctor finder tool is so helpful. These platforms allow you to search for GI doctors who take your insurance, have expertise in specific digestive disorders and are accepting new patients near you.
The bottom line
When it comes to your health, early action matters. If you’re experiencing ongoing abdominal pain, IBS, GERD or other GI symptoms, trust your gut. Speak up. Ask for a referral. Use digital tools to find the right gastroenterologist. And go to your appointment informed and empowered.
