What does a proctologist do?

A proctologist is a surgeon who specializes in the examination and treatment of diseases of the rectum. At the proctology outpatient clinic, inter alia, hemorrhoidal disease, inflammation of the rectum, benign and malignant tumours, rupture of the mucous membrane, so-called fissure, lesions of the lower intestinal tract and the rectum are examined and treated. Examination of rectal bleeding as the most common symptom is also the responsibility of a proctologist.

In case of what problems should we consult a proctologist?

With rectal complaints, such as:

  • Pain in the rectum, anus
  • Rectal bleeding or blood clots
  • A lump that forms or protrudes in the anus
  • Wound in or around anus
  • Feeling of rectal discomfort
  • Painful bowel movements
  • Difficulty passing stools or other disorders
  • Feeling of rectal fullness, false stool stimulation
  • Disorders of stool or intestinal gas retention
  • Rectal discharge from or around the rectum
  • Burning, itchy complaints of the anus

The following diseases may be the background of the complaints, and their diagnosis and specific treatment is the responsibility of the speciality:

  • Haemorrhoid disease: acute, chronic, external, internal
  • Rupture of rectal mucosa (fissure): acute, chronic, ulcerative, scarring
  • Anal fistula: low, high, and associated with other diseases of the abdominal cavity
  • Abscesses: around the anus, perineal, around the rectum, pelvic
  • Rectal polyp: benign and malignant
  • Other Benign and malignant tumours
  • Inflammatory diseases of the rectum: acute, chronic, locally localized, or associated with another disease
  • Rectal infection disease, lesions: caused by bacteria, fungi, viruses (HPV)
  • Injuries to rectal sphincters: obstetric, surgical, accidental.

Steps of proctological investigation:

First specialist examination:

Accurate medical history survey: local and general

View and examination of the anus and its surroundings.

Palpation of the anus, anal canal and rectal ampoule, the so-called rectal, manual / digital examination.

Anuscopy, which is a fine device with a transparent wall that is at least as thick as a human finger, allows you to view the lower 5 cm section of the anal canal and rectal ampoule by a light source.

Further examinations:

If necessary, the higher section – up to 15-25 cm depending on the body shape – can be reviewed with the so-called rectoscopy, i.e. rectal mirroring. Rectal imaging can be performed on an outpatient clinic after proper preparation, but without anaesthesia and intoxication

Colon mirroring may be required in cases where the specialist is looking for a non-rectal bleeding source or disease. Requires preparation, intoxication or anaesthesia, monitoring is required after the examination

Sampling from anal or rectal lesions for histological examination (biopsy)

If necessary, sampling of the inflamed, wounded, exuding, infected area: for the microbiological identification of fungi, bacteria and viruses

To find the course of fine probing of a fistula passage

Contrast agent loading examination of the fistula passage (Fistulography) if necessary

If necessary, ultrasound examination of the region, pelvis

CT, MR imaging of the rectum, rectal area, pelvis

Important information: The same or similar symptoms may have different pathologies.

Reasons for rectal bleeding may include the following:

  • External haemorrhoids
  • Internal haemorrhoids
  • Mucosal rupture
  • Infected disease of the anus
  • Polypus
  • Cancer
  • Inflammation of the rectum
  • Rectal fistula

The lump that appears in the anus may be the following:

  • External haemorrhoids
  • Protruding internal haemorrhagic lump
  • Viral wart (condyloma nodule)
  • An additional lump associated with mucosal rupture
  • Enlarged mucosal lump left after previous haemorrhoids
  • Inflammation of the hair follicles, onset of abscess
  • Excess tissue around the fistula opening
  • Polypus
  • Malignant lesion

Causes of rectal pain may include the following:

  • External haemorrhoids
  • Internal haemorrhoids
  • Mucosal rupture, ulceration
  • Fistula
  • Abscess
  • Inflammation
  • Infected wound
  • Advanced malignancy
  • Injury
  • Foreign body

Other diseases: inflammation of the prostate, inflammation of the urinary tract or stone, gynaecological disease, pelvic abscess

Determining the exact diseases responsible for the complaints is an absolute task for a specialist, and their investigation requires serious professional training, experience and clinical background! Serious mistake can arise from “online diagnosis”!