Colorectal Surgeon vs Gastroenterologist: Key Differences

• Colorectal surgeons handle surgical treatments for digestive disorders, while gastroenterologists focus on non-surgical, medical management of conditions.
• Career outlooks for both specialties are strong, with gastroenterologists generally having more predictable work hours and colorectal surgeons facing longer, on-call shifts.
• Choosing between the two specialties depends on whether you prefer a medical or surgical approach and your personal work-life balance preferences.

Digestive health plays a crucial role in our overall well-being, affecting everything from energy levels to immunity. Two specialists who focus on digestive health are colorectal surgeons and gastroenterologists. 

Colorectal surgeons focus on treating conditions like cancer and diverticulitis, whereas gastroenterologists manage digestive diseases. While both work with the same system, their approaches differ. 

In this blog, we’ll break down the differences between a colorectal surgeon vs gastroenterologist, helping you understand what each specialty entails, their unique roles, and which might be a better fit depending on your health needs.

Colorectal Surgeon vs Gastroenterologist

Colorectal surgeons and gastroenterologists focus on digestive health but play different roles. Gastroenterologists diagnose and treat issues related to the digestive tract using non-surgical methods. They typically complete internal medicine training followed by a fellowship in gastroenterology.

Colorectal surgeons, on the other hand, handle problems specifically in the colon, rectum, and anus, often through surgery. They go through general surgery training before specializing in colorectal surgery.

You’d visit a gastroenterologist if you need a colonoscopy or help managing Crohn’s disease. If polyps found during a colonoscopy require removal or you need surgery for colon cancer, a colorectal surgeon steps in. Simply put, gastroenterologists diagnose and manage, while colorectal surgeons operate when surgery is necessary.

Roles and Responsibilities

Gastroenterologists and colorectal surgeons are key to digestive health, each handling responsibilities of their own and contributing to the same cause.

Colorectal Surgeon

Colorectal surgeons focus on the colon, rectum, and anus, primarily using surgical methods to treat diseases in these areas. 

These specialists handle many responsibilities, such as: 

• Performing surgeries for colon cancer and polyp removal
• Conducting minimally invasive procedures (e.g., laparoscopic and robotic-assisted surgeries)
• Treating conditions like hemorrhoids, anal fistulas, and inflammatory bowel disease
• Collaborating with gastroenterologists for comprehensive care, especially for complex cases needing both medical and surgical intervention

Gastroenterologist

Gastroenterologists specialize in diagnosing and managing digestive system disorders, including issues with the stomach, intestines, liver, pancreas, and esophagus. Their main focus is on non-surgical treatments. 

Typical tasks performed by gastroenterologists include:

• Conducting endoscopies to examine the digestive tract
• Managing chronic digestive diseases (e.g., Crohn’s disease, ulcerative colitis)
• Providing preventive care through screenings like colonoscopies
• Treating conditions like heartburn, irritable bowel syndrome, and liver diseases
• Collaborating with patients on symptom management through medication and lifestyle changes

Educational and Training Pathways

Both specialties require extensive education and training, culminating in expertise within their respective fields. Though the path looks similar, the main difference lies in their specialization—gastroenterologists focus on diagnosis and medical management, while colorectal surgeons are experts in surgical solutions.

Colorectal Surgeon

Similarly, colorectal surgeons are required to complete an intense medical school program followed by a residency and fellowship. The key focus is on surgical intervention, including cancer surgeries, polyp removal, and complex colorectal procedures. This takes 14-15 years.

• Bachelor’s Degree (4 years) – Pre-medical education
• Medical School (4 years) – General medical training
• General Surgery Residency (5-6 years) – Comprehensive surgical training across various body systems
• Colorectal Surgery Fellowship (1 year) – Specialized surgical techniques for the colon, rectum, and anus, including minimally invasive and robotic-assisted procedures

Gastroenterologist

The education and training phase for gastroenterologists emphasizes knowledge in diagnosing and managing digestive diseases without surgery, and it starts with pre-medical training to medical school and residency. This takes a total of 14 years to complete.

• Bachelor’s Degree (4 years) – Pre-medical education
• Medical School (4 years) – General medical training
• Internal Medicine Residency (3 years) – Focuses on overall adult medicine and managing chronic illnesses
• Gastroenterology Fellowship (3 years) – Specialized training in digestive system disorders, endoscopies, and non-surgical treatments

Necessary Skills and Personality Traits

Due to the distinct nature of their work, being a gastroenterologist or a colorectal surgeon requires a unique set of skills to be able to carry out tasks effectively. 

Colorectal Surgeon

Colorectal surgeons need exceptional technical and decision-making abilities due to the surgical nature of their work. They perform complex procedures that require precision and quick problem-solving. Key skills include:

• Dexterity for performing delicate surgeries with accuracy
• Problem-solving skills to address unexpected complications during operations
• Ability to work under pressure in high-stakes surgical environments
• A precise hand to minimize risks and improve patient outcomes
• Leadership and teamwork to coordinate with surgical teams effectively

This specialty suits individuals who thrive in fast-paced, high-pressure situations and have a passion for hands-on, surgical problem-solving.

Gastroenterologist

Gastroenterologists require a combination of analytical thinking and patient-centered communication. Their role involves diagnosing complex digestive issues and managing chronic diseases, often requiring long-term patient relationships. Essential skills include:

• Strong analytical skills to interpret diagnostic tests and identify underlying issues.
• Patience for managing chronic conditions that require ongoing treatment.
• Attention to detail when conducting endoscopies or reviewing lab results.
• Communication skills to explain medical conditions and treatment plans clearly.
• Empathy to build trust with patients experiencing discomfort or anxiety.

This role suits individuals who enjoy problem-solving through observation and dialogue, with a focus on long-term care and non-surgical treatments.

Common Conditions Treated

Gastroenterologists and colorectal surgeons focus on digestive health but treat different conditions and use distinct approaches. Some conditions overlap, but the treatment method varies depending on the severity and nature of the disease.

Gastroenterologists focus on long-term medical management, while colorectal surgeons perform surgeries when complications arise.

Colorectal Surgeon

Colorectal surgeons address diseases of the colon, rectum, and anus, with the most common being:

• Colon and rectal cancer: Surgical removal of tumors and affected tissues.
• Hemorrhoids: Treated through minimally invasive procedures or surgical removal.
• Diverticulitis: In severe cases, surgery is required to remove the affected part of the colon.
• Anal fistulas: Repaired surgically to prevent infection and discomfort.
• Rectal prolapse: Corrected through surgical intervention to restore proper anatomy.

Gastroenterologist

Gastroenterologists focus on maintaining long-term digestive health and preventing complications. Common conditions they treat include:

• GERD (Gastroesophageal Reflux Disease): Managed with medication and lifestyle changes.
• Irritable Bowel Syndrome (IBS): Treated through dietary adjustments and medication.
• Crohn’s disease and Ulcerative colitis: Managed with medication to reduce inflammation and control symptoms.
• Celiac disease: Treated through strict gluten-free diets.
• Peptic ulcers: Treated with antibiotics (if caused by H. pylori) and acid-reducing medications.
• Liver disease: Managed with medication, lifestyle changes, and monitoring of liver function.

Performed Procedures

Gastroenterologists and colorectal surgeons perform specialized procedures to diagnose and treat digestive system conditions. 

Colorectal Surgeon

Colorectal surgeons perform surgical procedures to treat diseases of the colon, rectum, and anus, particularly when non-surgical treatments are ineffective. These procedures are often more invasive but necessary for long-term solutions. Common procedures include:

• Colectomy: Removing part or all of the colon, commonly used to treat colon cancer or severe ulcerative colitis.
• Bowel resection: Removing a diseased section of the intestine and reconnecting the healthy parts, used for Crohn’s disease or bowel obstructions.
• Hemorrhoidectomy: Surgical removal of severe hemorrhoids that don’t respond to non-surgical treatments.
• Robotic–assisted surgery: Using advanced robotic technology for precise, minimally invasive procedures, reducing recovery time.
• Stoma creation (colostomy or ileostomy): Creating an opening in the abdomen to allow waste to exit the body, often necessary after bowel resection or colectomy.

Gastroenterologist

Gastroenterologists perform non-surgical procedures to diagnose and manage digestive disorders. These procedures allow for a detailed examination of the digestive tract and targeted treatment. Common examples include:

• Endoscopies: Using a flexible tube with a camera to examine the esophagus, stomach, and intestines. This helps diagnose GERD, peptic ulcers, and celiac disease.
• Liver biopsies: Taking small samples of liver tissue to diagnose liver diseases, such as hepatitis or cirrhosis.
• Polyp removal (polypectomy): Removing polyps during a colonoscopy to prevent them from becoming cancerous.
• Dilation of strictures: Widening narrowed areas in the esophagus or intestines to relieve swallowing difficulties or bowel obstructions.

Career Outlook and Job Prospects

While both fields offer rewarding opportunities, they differ in terms of job responsibilities, salary potential, and work-life balance.

Colorectal Surgeon

Colorectal surgeons are in high demand, particularly as the population ages and the incidence of colorectal diseases rises. As of January 2025, the average annual salary for a colorectal surgeon in the United States is approximately $248,571, which translates to about $119.51 per hour.

The career outlook for colorectal surgeons remains positive, with opportunities in both urban and rural settings. However, the nature of surgical work often requires longer hours, including on-call duties and emergency surgeries, which can impact work-life balance.

Gastroenterologist

Gastroenterologists are also in high demand due to the increasing prevalence of digestive disorders and an aging population. Reports have also predicted a shortage of physicians by 2036, gastroenterologists included, making this role a wise career choice.

As of January 2025, the average annual salary for a gastroenterologist in the United States is approximately $379,519, equating to about $182.46 per hour. However, salaries can vary based on factors such as geographic location, years of experience, and the type of healthcare facility. 

Regarding work-life balance, gastroenterologists often have more predictable hours compared to surgeons, with fewer emergency calls and a more structured schedule, contributing to a favorable work-life balance.

Which Specialty Is Right for You?

Choosing between becoming a gastroenterologist or a colorectal surgeon career is a big decision, and it really comes down to what excites you and what fits your lifestyle. 

If you’re someone who enjoys long-term patient relationships and prefers a less hands-on, surgical approach, gastroenterology could be your perfect fit. You’ll be diagnosing and managing digestive diseases, often building relationships with patients over time. Plus, the hours tend to be more predictable, which is great if you value a balanced life outside of work.

On the flip side, if you thrive in high-pressure environments and love the idea of performing surgeries that make a direct, physical impact, then colorectal surgery might be for you. 

You’ll need to be comfortable with longer hours, being on-call, and dealing with more urgent cases. The work is incredibly rewarding but requires a certain mindset: quick thinking, surgical precision, and the ability to work well under pressure.

Ultimately, it’s all about what drives you. Think about your strengths—do you want to solve problems through medicine and preventive care, or is the surgical route more your speed? 

Lifestyle matters, too. If a consistent, structured day sounds appealing, gastroenterology might be your answer. If you’re drawn to a fast-paced, sometimes unpredictable routine, colorectal surgery could be the right path.

Conclusion

Having their specialties in mind, we have concluded that gastroenterologists and colorectal surgeons both play essential roles in digestive health, but they approach it differently.

Gastroenterologists focus on diagnosing and managing digestive conditions without surgery, while colorectal surgeons specialize in performing surgeries to treat more complex conditions. Gastroenterologists typically enjoy more predictable hours, whereas colorectal surgeons often deal with emergencies and longer shifts. 

Both paths offer rewarding careers, so it’s all about what excites you—whether it’s non-surgical care or surgical precision. If you’re considering a medical career at AUAMED with our Clinical Science Program, these specialties are just a glimpse of the opportunities waiting for you!

Frequently Asked Questions (FAQs):

Can a colorectal surgeon perform a colonoscopy?

Yes, a colorectal surgeon can perform a colonoscopy, as it is part of their training to examine the colon and diagnose conditions. However, colonoscopies are more commonly performed by gastroenterologists, who specialize in the medical management of digestive diseases.

Is colorectal considered gastroenterology?

Colorectal surgery is not considered part of gastroenterology; rather, it is a distinct surgical specialty focused on treating conditions of the colon, rectum, and anus through surgical intervention.