Proctology, also known as colorectal surgery, is a field in medicine that focuses on the diagnosis and treatment of diseases or disorders of the colon, rectum, and anus. The one who specializes in proctology is called a proctologist or a colorectal surgeon.
What is a proctologist?
A proctologist is a medical doctor who has an advanced training and extensive education in dealing with medical issues concerning the lower gastrointestinal tract (colon, rectum, anus). A proctologist also works as part of a healthcare team, which may consist of nurses, general practitioners, dietitians, gastroenterologists, anesthesiologists, and radiologists.
At present, proctologists are called as colorectal surgeons or colon and rectal surgeons. These specialists perform surgical procedures for the treatment of lower digestive tract problems, such as hemorrhoids, inflammatory bowel diseases, diverticulitis, colorectal polyps, colorectal cancer, and bowel incontinence.
Colorectal surgeons also perform both screening and diagnostic tests, which include ultrasound scans, flexible sigmoidoscopies, biopsies, and colonoscopies. They assure patients of a proper diagnosis and treatment of certain conditions that may be embarrassing to talk about, such as painful bowel movements, anal itching, and hemorrhoids.
Sometimes, there is confusion between proctologists and gastroenterologists. Even though both specialists deal with gastrointestinal issues, their specialties are different from each other. Gastroenterologists diagnose and treat digestive problems, but they do not perform surgical procedures as a method of treatment, which is the area of specialty of proctologists.
In most cases, patients are referred to proctologists if they have digestive tract problems that may need specialty care.
To become a proctologist, years of education and training are needed. After earning a bachelor's degree, four years in medical school are required. After medical school, a residency training of 5-6 years in general surgery is required followed by another 1-2 years of colorectal surgery fellowship.
All aspiring physicians are required to hold a license to practice. They have to undergo a medical licensing examination and obtain their license from the American Board of Colon and Rectal Surgery before becoming a board-certified proctologist.
Proctologists must also have annual continuing education units, which can be obtained through medical conferences, medical centers, and medical schools. Every after 10 years, a recertification is also required.
To succeed as a colorectal surgeon, you must have the following:
- A genuine interest in healthcare and science
- Compassion and empathy
- Good interpersonal and communication skills
- Good observation skills
- Good attention to details
- Strong analytical skills
- Good problem-solving skills
- Generally and physically fit
Reasons to Visit a Proctologist
Below are some of the reasons that would warrant a visit to a proctologist:
- Hemorrhoids (piles)
- Rectal bleeding
- Anal fistula
- Anal fissure
- Changes in bowel habits
- Changes in bowel movements
- You have developed anemia due to chronic gastrointestinal bleeding or other lower gastrointestinal tract problems.
- A family history of colorectal cancer or colon polyps.
- A history of polyps with the need of a follow-up colonoscopy.
- Anal discharge that is potentially caused by sexually transmitted diseases (STDs).
- The presence of inflammation or an abscess (collection of pus) on the buttocks.
- If you are more than 50 years old with the need for a colonoscopy screening.
- If you have irritable bowel syndrome (IBS) and want to know your options when it comes to managing the disease.
- If you need to undergo a surgical procedure for colorectal cancer, ulcerative colitis, Crohn’s disease, inflammatory bowel disease, or inflammation of the diverticula in the colon called diverticulitis.
Mild to moderate hemorrhoids can be diagnosed and treated by general practitioners or family physicians. Antihemorrhoid drugs are initially prescribed by doctors, but if hemorrhoids fail to respond to these medications, patients are usually referred to a proctologist for further evaluation and treatment.
Minor to mild rectal bleeding that occasionally occurs usually do not require medical treatment. However, chronic rectal bleeding that is accompanied by severe rectal pain may indicate a more serious underlying problem that must be evaluated by a doctor.
When a person has rectal bleeding, he or she may notice the presence of blood in their underwear and toilet paper or toilet water after bowel movements. They may also find drips or streaks of blood in their stool or toilet bowl during or after bowel movements.
In some cases, people may pass stools that appear dark or tarry with a foul smell when they have rectal bleeding. See a doctor if you have any of the following symptoms that accompany rectal bleeding:
- Chronic constipation
- Changes in bowel habits
- Abdominal lumps
- Painful or swollen abdomen
- Weakness and fatigue
- Unexplained or unintentional weight loss
- Rectal bleeding for more than two weeks
- Passing bloody stools
- Fecal or bowel incontinence
- Passing narrow, thin, and soft stools for more than three weeks
Seek emergency medical care if rectal bleeding is accompanied by the following symptoms:
- Rectal bleeding that is black or very dark red in color
- Coughing up or vomiting blood
- Unexplained bloody diarrhea
- Bleeding from the eyes, ears, or nose
- Severe lower back pain or abdominal pain
- Loss of consciousness
Procedures Performed by Proctologists
Most colorectal procedures involve the use of laparoscopic surgery. However, not all patients are good candidates for a laparoscopic surgery. Those who have large tumors, have had abdominal surgeries multiple times, and have a severe cardiopulmonary disease may not be suitable for this type of procedure.
Patients who have undergone a laparoscopic surgery have a lower surgical wound infection rate with a faster recovery and less postoperative pain. Fewer complications are also experienced by these patients.
Other minimally invasive methods that proctologists perform include:
- Latex ligation
- Coagulation therapy or infrared photocoagulation
- Disarterization of hemorrhoid nodes
- Radiowave ablation
Surgeries performed by colorectal surgeons include:
- Endoscopic Surgery
- Laparoscopic rectopexy
- Ileal-pouch anal anastomosis (IPAA) surgery or J-pouch surgery
- Inflammatory Bowel Disease (IBD) Surgery
- Anal sphincterotomy
After undergoing any of these procedures, allow your body to have enough time to heal. A medical team usually discuss the recovery process with you. Depending on your overall health status, complete recovery may take up to six weeks. During the recovery period, a liquid diet is followed until normal bowel functions return. Moreover, activities that put a strain on the abdomen, such as coughing, lifting, and straining during passing stools must be avoided.