By Dr Udit Mittal, MBBS, MRCP(UK), FRCP(London), FRCP(Edin), Consultant Gastroenterologist and Endoscopist
Medically reviewed: September 2026
When to see a gastroenterologist: the short answer
You may benefit from seeing a gastroenterologist when digestive symptoms persist, repeatedly return, remain unexplained or do not improve with initial treatment. Specialist assessment is particularly important when symptoms are accompanied by bleeding, unexplained weight loss, iron-deficiency anaemia, difficulty swallowing, a persistent change in bowel habit or abnormal blood or stool tests.
A gastroenterology appointment does not automatically mean that you will need a gastroscopy, colonoscopy or scan. The first step is usually to understand your symptoms, medical history and previous results, then decide whether further investigation is likely to change your care.
Ten reasons to consider gastroenterology assessment:
- persistent or recurrent abdominal pain;
- ongoing bloating or visible abdominal distension;
- persistent diarrhoea, constipation or a change in bowel habit;
- blood in the stool, rectal bleeding or a positive FIT result;
- unexplained iron-deficiency anaemia;
- unintentional weight loss;
- reflux or indigestion that has not improved with appropriate treatment;
- difficulty or pain when swallowing;
- abnormal liver, pancreatic, blood or stool-test results;
- digestive symptoms that continue despite previous tests or treatment.
What does a gastroenterologist treat?
A gastroenterologist is a doctor specialising in conditions affecting the digestive system. This includes the oesophagus, stomach, small bowel, colon, rectum, liver, gallbladder, bile ducts and pancreas.
Common reasons for assessment include abdominal pain, bloating, persistent diarrhoea, constipation, acid reflux, difficulty swallowing, rectal bleeding, iron deficiency and unexplained digestive symptoms.
Gastroenterologists also diagnose and manage conditions such as irritable bowel syndrome (IBS), coeliac disease, inflammatory bowel disease, microscopic colitis, bile acid diarrhoea, liver disease, pancreatic disorders and gastrointestinal polyps.
Ten signs you should consider seeing a gastroenterologist
1. Persistent or recurrent abdominal pain
Abdominal pain has many possible causes and does not always arise from a visible structural problem. If pain persists for several weeks, repeatedly returns, is becoming more troublesome or remains unexplained after initial assessment, a gastroenterologist can review whether further investigation or a different treatment approach is appropriate.
2. Ongoing bloating or abdominal distension
Occasional bloating is common. Persistent bloating can be associated with constipation, IBS, coeliac disease, disorders of gut–brain interaction and, in selected cases, small intestinal bacterial overgrowth. Specialist assessment can help distinguish bloating, visible distension, altered bowel movement and dietary triggers without resorting to unnecessarily restrictive diets.
3. A persistent change in bowel habit
This may include ongoing diarrhoea, new or worsening constipation, alternating bowel habits, increasing urgency, incomplete emptying or a sustained change in stool frequency or consistency. The importance of a change depends on age, duration, associated symptoms, family history and previous investigations.
4. Blood in the stool or a positive FIT test
Rectal bleeding is often caused by haemorrhoids or an anal fissure, but it should not automatically be assumed to be due to piles. Persistent or unexplained bleeding may require investigation. A positive FIT result does not mean that you have bowel cancer, but it needs to be interpreted alongside symptoms, age, blood results and previous investigations.
Read more about rectal bleeding and blood in the stool.
5. Chronic diarrhoea or difficult-to-treat constipation
Diarrhoea lasting several weeks or repeatedly returning can have causes including IBS, bile acid diarrhoea, coeliac disease, inflammatory bowel disease, microscopic colitis, medication effects, infection and pancreatic insufficiency. Constipation can involve hard stools, straining, slow transit or difficulty coordinating the pelvic floor, even when bowel movements occur regularly.
6. Reflux or indigestion that is not improving
Occasional heartburn can often be managed in primary care. Gastroenterology assessment may be helpful when reflux remains troublesome despite treatment, frequently returns, has an uncertain diagnosis or is associated with swallowing difficulty, vomiting, weight loss or anaemia.
7. Difficulty swallowing
Difficulty swallowing, or dysphagia, can involve food sticking in the throat or chest, difficulty with solid food or liquids, coughing when eating or recurrent food impaction. Persistent or progressive dysphagia should be medically assessed rather than repeatedly treated as uncomplicated reflux.
8. Iron-deficiency anaemia or unexplained weight loss
Iron-deficiency anaemia can sometimes result from gastrointestinal blood loss or impaired absorption. Potential causes include coeliac disease, inflammation, ulcers and polyps. Similarly, unintentional weight loss should be interpreted in the context of appetite, bowel symptoms, blood tests and general health.
9. Abnormal blood, liver, pancreatic or stool tests
Abnormal liver enzymes, inflammatory markers, calprotectin, faecal elastase, FIT or coeliac blood tests may require specialist interpretation. The result should be assessed with symptoms and medical history rather than considered in isolation.
10. Symptoms continue despite previous tests or treatment
A normal scan, gastroscopy or colonoscopy can be reassuring, but it does not assess every aspect of digestive function. Persistent symptoms may relate to disorders of gut–brain interaction, altered sensitivity, bile acid diarrhoea, pelvic-floor dysfunction, motility changes or other treatable problems. Read more about persistent digestive symptoms despite normal tests.
What happens at a gastroenterology consultation?
The first consultation is primarily a detailed clinical assessment. It is not normally an automatic procedure appointment.
A gastroenterologist will usually ask about:
- the nature, duration and pattern of symptoms;
- bowel habit, diet and weight changes;
- medicines and previous treatment;
- medical and surgical history;
- relevant family history;
- previous blood, stool, imaging or endoscopy results;
- how symptoms affect eating, sleep, work and daily life.
Where appropriate, examination may be recommended. The next step might be reassurance, treatment, a targeted investigation, review of previous results or a period of monitoring. Bringing a medication list, previous reports and a brief symptom timeline can make the appointment more useful.
What tests might a gastroenterologist arrange?
Tests should be selected to answer a meaningful clinical question. Depending on the circumstances, these may include:
- Blood tests for anaemia, inflammation, coeliac disease, liver abnormalities or nutritional deficiencies.
- Stool tests for inflammation, infection, microscopic blood or pancreatic digestive function.
- Gastroscopy to examine the oesophagus, stomach and first part of the small bowel.
- Colonoscopy to examine the colon and the end of the small bowel.
- Ultrasound, CT or MRI when imaging is more suitable than endoscopy.
- Specialist functional tests for selected problems involving bile acids, reflux, oesophageal movement, bowel transit, bacterial overgrowth or pelvic-floor function.
Not every person with digestive symptoms needs endoscopy. Equally, when an investigation is clinically justified, its purpose, benefits, limitations and alternatives should be explained clearly.
Do I need a GP referral to see a private gastroenterologist?
Self-paying patients may be able to arrange a private gastroenterology appointment directly, depending on the consultant and hospital. If you have private medical insurance, check the policy before booking because many insurers require a GP referral or pre-authorisation.
Does seeing a gastroenterologist mean I will need a colonoscopy?
No. A consultation and an endoscopic procedure are separate decisions. Many patients attending a gastroenterology appointment do not require a colonoscopy or gastroscopy.
The purpose of specialist review is to determine whether investigation is necessary and, if so, which test is most likely to answer the clinical question. Sometimes treatment, monitoring or review of previous tests is more appropriate than repeating an invasive investigation.
Private gastroenterologist in Oxford, Banbury and Aylesbury
Dr Udit Mittal is a Consultant Gastroenterologist and Endoscopist at Oxford University Hospitals and provides private gastroenterology consultations at:
- Oxford: The Manor Hospital;
- Banbury: The New Foscote Hospital;
- Aylesbury: The Royal Buckinghamshire Hospital.
Consultations are available for patients from Oxfordshire, Buckinghamshire and surrounding areas, including the Cotswolds, Warwickshire, Northamptonshire, Berkshire, Bedfordshire, Milton Keynes and London. Telephone or video consultations may also be suitable in some circumstances.
Request a private gastroenterology appointment, review consultation fees or explore the full range of gastroenterology services.
Frequently asked questions
What symptoms should I see a gastroenterologist for?
Persistent abdominal pain, bloating, diarrhoea, constipation, a change in bowel habit, rectal bleeding, reflux, difficulty swallowing and unexplained digestive symptoms are common reasons for assessment. Whether you personally require specialist review depends on the symptoms, duration, age, medical history and any warning features.
Should I see a gastroenterologist for IBS?
Many people with IBS can be managed successfully in primary care. Specialist assessment may be useful when the diagnosis remains uncertain, symptoms are particularly troublesome, standard treatments have not helped or another condition needs to be considered.
What should I bring to my first appointment?
Bring a current medication list, previous blood or stool results, scan or endoscopy reports and a brief record of symptom timing. Insurance authorisation or a GP referral may also be required depending on how the appointment is funded.
Will I have a procedure at my first gastroenterology appointment?
Usually not. The first visit normally focuses on history, previous results and a plan. If gastroscopy, colonoscopy or another test is recommended, this is generally arranged separately after the reasons and alternatives have been discussed.
Can a gastroenterologist help when tests are normal?
Yes. Normal tests can be reassuring, but symptoms may persist because of gut sensitivity, altered motility, disorders of gut–brain interaction, dietary factors or conditions not measured by previous investigations. A specialist can review whether anything important has been missed and whether treatment should focus on a different mechanism.
Arrange a private gastroenterology consultation
If you have persistent or unexplained digestive symptoms and would like a specialist opinion, you can arrange a private consultation with Dr Udit Mittal in Oxford, Banbury or Aylesbury.
The aim is to understand your symptoms, review previous investigations and decide together whether further testing or treatment is appropriate. Not everyone needs an invasive investigation.
Request an appointment or contact Dr Mittal’s secretary.
About the author
Dr Udit Mittal, MBBS, MRCP(UK), FRCP(London), FRCP(Edin), is a Consultant Gastroenterologist and Endoscopist at Oxford University Hospitals. He is nationally accredited as an NHS Bowel Cancer Screening Programme colonoscopist.
This page provides general health information and does not replace an individual medical assessment. If you are acutely unwell or concerned that you may need urgent medical attention, use the appropriate NHS urgent or emergency service.