A proctologist is responsible for diseases in the area of the rectum. These include serious diseases such as Crohn’s disease or colon cancer, as well as conditions such as hemorrhoids or anal fissures, which are treated surgically or non-invasively by the proctologist.
What is a proctologist?
A proctologist is responsible for diseases of the rectum. These include serious diseases such as Crohn’s disease or colon cancer, as well as conditions such as hemorrhoids or anal fissures. A proctologist is a specialist with additional training in proctology and specializes in diseases of the colon as well as the rectum. The specialization therefore includes general basic knowledge of surgery as well as additional knowledge of clinical pictures of the lower digestive tract. In addition to colorectal cancer and serious inflammatory bowel diseases such as Cohn’s disease or ulcerative colitis, a proctologist’s field of treatment also includes bowel diseases that require surgical intervention on a smaller scale, such as hemorrhoids, tears in the mucous membrane of the anus, rectal prolapse or fecal incontinence. Some proctologists also treat pelvic floor disorders such as perineal hernia or rectocele. To acquire the necessary qualification, a completed undergraduate medical degree is generally required, as well as a residency, in most cases specializing as an internist or gastroenterologist. For the designation of proctologist, a further one-year study is necessary, numerous further training courses complement the qualification of the profession of proctologist.
Treatments
A proctologist’s range of treatments includes procedures on the colon, rectum, and anus using a variety of procedures that have minor or significant long-term effects on the patient. In addition to prescribing medications (e.g., ointments), uncomplicated minor treatments can be performed, such as for hemorrhoids by interrupting blood circulation (sclerotherapy). Growths and the formation of scar tissue in the rectum can lead to obstructions that prevent the outflow of excretions. Other diseases such as ulcerative colitis and diverticulitis can cause perforations in the rectum. A surgical procedure performed by a proctologist is used to create an opening from inside the body to the outside to remove bodily waste. A colostomy involves pulling part of the colon through the abdominal wall, while an ileostomy requires removal of the entire colon, rectum and anus. Most colostomies and ileostomies placed by a proctologist are permanent. Temporary colostomies are used to allow diseased sections of the bowel to recover and heal. In more modern laparoscopic surgery, tiny instruments are inserted by the proctologist through a small incision in the abdomen and guided by a small camera.
Diagnostic and examination methods
Some diseases can be treated by the proctologist using minimally invasive surgery. The proctologist determines whether surgery is necessary based on an extensive medical history, the severity of any pain experienced, and the results of various diagnostic tests. Unless visual inspection or palpation can already provide a diagnosis, procedures such as colonoscopy, sigmoidoscopy, and radiologic examinations can help to visualize the condition of the digestive tract. Gastroenterological radiology allows for the identification of ulcers, cysts, polyps, diverticula (pouches in the intestine) or cancer by means of various X-ray examinations of the colon and rectum using a barium enema. Sigmoidoscopy involves inserting a flexible tube with a miniature camera into the rectum so that the proctologist can examine the mucosa of the rectum and the last third of the intestinal tract or remove tissue for a biopsy. This examination is one of the most important screening tests for colorectal cancer. A colonoscopy under the influence of an anesthetic allows the proctologist to examine the entire intestinal tract. Also using a miniature camera, an endoscopy by the proctologist examines the lining of the esophagus (food pipe), stomach and duodenum. A proctologist uses magnetic resonance imaging (MRI) both before and during surgery to determine the exact location of diseased tissue. For optimal preparation of an operation, a proctologist can also order blood and urine samples or an ECG.
What should the patient pay attention to?
Due to the particular intimacy of the affected body section, affected persons often conceal their complaints and only seek a proctologist at a late stage. As a rule, the attending family physician will issue an appropriate referral to a suitable proctologist. These are either in hospitals, proctological outpatient clinics or established as independent physicians. Ultimately, a patient will have to overcome his or her sense of shame to enable successful treatment. In this respect, the atmosphere in the practice and in the initial consultation with the proctologist should be coherent.
