Last updated date: 11-Jul-2023
Originally Written in English
Coloproctology is known as the study, diagnosis, and management of colorectal disorders, such as issues with the colon, rectum, and anus. The surgical specialty of coloproctology, commonly referred to as colorectal surgery, deals with the examination, diagnosis, and treatment of all colorectal diseases, such as issues with your colon, gut, rectum, and appendix.
What Do Proctologists Do?
Proctologists are surgeons who identify and treat conditions of the colon, rectum, and anus. Colon and rectal surgeons and colorectal surgeons are other names for them. For complex conditions involving the lower digestive tract or when surgery is required, you might visit a colorectal surgeon. Hemorrhoids and anal fissures can be treated medically by a colon and rectal surgeons. If the situation calls for surgical intervention, they do surgery.
What Coloproctology Involves?
Hemorrhoids, anal fissures and fistulas, anal warts, pilonidal cysts, anal cancer, rectal cancer, rectal prolapse, colorectal cancer, diverticulitis, inflammatory bowel diseases like Crohn's and ulcerative colitis, and pelvic floor disorders like fecal incontinence, chronic constipation, irritable bowel syndrome (IBS), and bowel dysfunction are among the common conditions that are treated. Colorectal illnesses can cause discomfort. While medication can occasionally help, surgery may also be required to alleviate the uncomfortable symptoms of colorectal issues.
Gastroenterologist vs Proctologist
There are certain intrinsic differences between the two specialties, even though gastroenterologists and proctologists treat many of the same gastrointestinal problems.
The primary distinction between a gastroenterologist and a proctologist is that the latter can do procedures, whilst gastroenterologists cannot.
Gastroenterologists receive training in internal medicine and gastroenterology, while proctologists receive training in general surgery, colon, and rectal surgery. Proctologists don't deal with problems involving the pancreas, liver, stomach, or inflammatory bowel disease or their medical management. Gastroenterologists will examine the digestive system as a whole to pinpoint the issue and determine which organs are being affected.
When a patient needs surgery and all other non-surgical treatments have been tried, gastroenterologists send patients to proctologists. Invasive procedures such as endoscopy, colonoscopy, or laparoscopy, which allow doctors to see the digestive tract, remove tiny polyps, and identify colon cancer, are performed by some gastroenterologists. A gastroenterologist will send you to a proctologist if the polyp is too large to be excised endoscopically or if a cancerous tumor needs to be surgically removed.
Diseases Treated with Coloproctology Surgery
Coloproctology Doctors provide treatment for a wide range of diseases that affect the colon, rectum, small intestine, and anus, such as:
The anus and anal canal, the little tube that links to your rectum and empties your body of feces, may be affected by anorectal disorders. Conditions that affect the rectum, the lower part of the large intestine (colon), may also be included. These diseases could include:
- Anal cancer. beginning within the anal canal.
- Anal condyloma. The most prevalent sexually transmitted disease (STD), human papillomavirus (HPV), causes warts around or inside the anus.
- Anal fissure. A tiny tear in the mucosa that normally lines the anal opening.
- Anal fistula. An unnatural tunnel connecting an inflamed anal gland to a skin opening grows beneath the skin.
- Anorectal abscess. a mass of pus under the skin that forms around the rectum and anus and is frequently brought on by an inflamed anal gland.
- Hemorrhoids. Veins that are swollen and bulging in the anus or lower rectum.
- Pilonidal sinus. a little skin tear at the top of the buttocks. A pilonidal cyst may develop if the hole fills with liquid or pus.
- Pruritus ani (perianal itching). Itching around the anus that is persistent and intense, frequently getting worse after a bowel movement or at night.
- Rectal polyps. a tiny growth in the rectum caused by excess tissue.
Among the more serious or advanced anorectal disorders are:
- Anorectal stricture (anorectal stenosis). It is narrowing of the anal or rectal canal that may make it challenging to evacuate feces.
- Fecal incontinence. loss of bowel control that results in unpredicted stool leakage.
- Rectal prolapse. A situation where the rectum pulls into the anal canal after slipping out of place normally.
- Retrorectal tumors. abnormal cell aggregates that proliferate and divide erratically in the retrorectal space. This is the region of the pelvis that is in front of the pelvic bones (sacrum) and behind the coccyx and rectum.
- Rectovaginal fistula. An unnatural vaginal-rectal connection that allows gas or feces to enter the vagina.
Any portion of the digestive tract, including the anus, rectum, and large intestine, might be affected by abdominal disorders. These conditions could include:
- Appendiceal tumors. Appendix tumors are tumors that begin in this little pouch on the right side of the colon. Mucoceles, cystadenomas, and adenocarcinomas are the most prevalent forms.
- Appendicitis. the appendix is inflamed. The appendix could rupture and transmit infection if it is not treated soon away. Emergency appendix removal surgery is often required for treatment.
- Carcinoid tumors. Tumors that develop from hormone-producing neuroendocrine cells. They frequently develop in the rectum, small intestine (the tube that links the stomach and large intestine), or appendix lining.
- Colon cancer. A form of cancer that develops as the colon's abnormal cells proliferate.
- Colonic polyps. a little growth that develops on the colonic inside lining. A polyp may not be cancerous at first, but if left untreated, it may turn into cancer.
- Colonic volvulus. When the colon bends around the tissue surrounding it, an emergency condition develops. It might cause a blockage in the digestive tract.
- Diverticulitis. Diverticula, which are tiny pouches that occur in the digestive tract, can become infected and inflamed.
- Enterocutaneous fistula. A crooked connection that develops between the skin and the stomach or gastrointestinal tract. The stomach or intestines' contents seep through the skin as a result.
- Familial adenomatous polyposis (FAP). An uncommon, genetic condition that results in the colon and rectum developing hundreds or thousands of polyps. It might result in colorectal cancer.
- Inflammatory bowel disease (IBD). a name for diseases that result in persistent (chronic) inflammation of the digestive tract.
- Crohn's disease. A form of IBD that can affect any area of the digestive system, including the mouth and the anus.
- Ulcerative colitis. A form of IBD that consistently inflames the full length of the large intestine (colon).
- Lower gastrointestinal (GI) bleeding. Large intestine bleeding.
Coloproctology Surgery Procedures
The doctors perform a variety of colorectal procedures, including:
- Colectomy. All or a portion of the colon is removed by the surgeon. Over the large intestine, they often create an incision in the abdomen. The colon may be cut in half, then the two ends may be reattached. Alternately, they could connect the small intestine to the rectum and remove the entire colon. A partial colectomy may be used to treat diverticulitis, IBD, or malignancy. Diseases including familial adenomatous polyposis, Crohn's disease, or ulcerative colitis may be treated by total colon resection.
- Colostomy. One end of the colon is inserted through a tiny hole the surgeon makes in the abdomen. This surgery requires the use of a colostomy bag, which sits outside the body and collects waste. To help the treated part of the colon recover, some people require a temporary colostomy. To address conditions like diverticulitis or Crohn's disease, some people may require a permanent colostomy.
- Hemorrhoidectomy. Hemorrhoids are removed by the surgeon through several tiny incisions made around the anus. Hemorrhoidectomy procedures are frequently performed as outpatient procedures, allowing patients to go home the same day. It's one of the best ways to treat hemorrhoids permanently.
- Ileal pouch-anal anastomosis (J-pouch surgery). After removing the colon, this procedure can restore intestinal function. At the end of the small intestine, the surgeon makes a little pouch and connects it to the anus. This allows patients to have more regular bowel movements by doing away with the need for a colostomy and waste bag.
- Sphincterotomy. Anal fissures frequently heal on their own without surgery. Patients might require an internal sphincterotomy if they don't, though. When having a bowel movement, the internal anal sphincter is the muscle that contracts or relaxes to allow stool to pass through the anal canal. An internal sphincterotomy involves the surgeon temporarily weakening the muscle by making a tiny incision in the internal anal sphincter. An anal fissure isn't physically removed or sealed during this operation, but the pressure around the fissure is reduced, allowing it to heal on its own.
- Polypectomy. A long, thin instrument with a camera called a colonoscope is inserted into the rectum by the surgeon to remove colon or rectal polyps. To excise polyps from the colon or rectum, they run a wire loop through the colonoscope.
- Rectopexy. Rectal prolapse is treated by colorectal surgeons using rectopexy. The rectum is normally moved, then fixed in place by being attached to the lower backbone (sacrum) after an abdominal incision.
Minimally Invasive Coloproctology Surgery
Less invasive surgery can result in a quicker recovery, a lower risk of infection, and less scarring. Whenever possible, colorectal surgeons employ a minimally invasive technique. Doctors also have the skills and knowledge necessary to carry out complex open treatments when minimally invasive surgery (MIS) isn't the safe or suitable method of treatment. MIS approaches could be:
- Laparoscopic surgery. The surgeon makes several little incisions at the belly button (navel) rather than one large one down the abdomen. Through the cuts, they insert a long, flexible instrument called a laparoscope and a camera. In doing so, they can work on the intestines without having to completely open the abdomen.
- Robotic surgery. Laparoscopic surgery and robotic surgery are identical. However, the surgeon directs a robotic arm fitted with surgical tools through the cuts rather than inserting a laparoscope and tools. At a specialized computer station in the operating room, the surgeon manages the robotic arm. During surgery, robotics can improve vision and accuracy.
- Transanal endoscopic microsurgery. This cutting-edge, minimally invasive technique can be used by surgeons to remove rectal tumors or cancer. Through the anus, the surgeon inserts highly specialized surgical tools. They can remove rectal polyps or tumors with this method without making an abdominal incision.
Recovery After Coloproctology Surgery
Your specific procedure and your body's response will determine how long it takes for you to recover and how long it takes you to have a coloproctology. To assist you to prepare for your discharge from the hospital, your colorectal surgeon will provide you with a planned date of discharge as well as comprehensive recovery instructions.
You will be encouraged to move around the hospital as much as you can comfortably while you are there to reduce discomfort, lower your chance of problems, and optimize your breathing. A light meal that is gradually increased will be followed by you. After your epidural or PCA is removed, you can keep your pain under control by taking painkillers.
You will frequently have your blood pressure, pulse, temperature, fluid balance, and weight monitored. If necessary, you will be taught how to manage a stoma on your own.
For a few weeks after you leave the hospital, you might want help with heavy tasks like grocery shopping, cleaning, and gardening. You should keep up your daily exercise routine and gradually increase it until you are back to your previous level of activity. Make sure you get plenty of sleep as well. For six weeks, you should refrain from participating in contact sports and hard lifting.
Certain foods may result in loose stools. If this occurs, you should refrain from eating those things for the first two weeks following your surgery and consume lots of fluids.
After your operation, you should be able to go back to work in two to four weeks. When you feel confident in your ability to drive safely, you can start driving again. A follow-up consultation will be scheduled to evaluate your progress.
How often Colonoscopy
No later than age 50, the majority of people should get checked for colon cancer. You should get a colonoscopy once more every ten years if there are no indications of cancer after the initial examination. Discuss with your doctor how frequently you should get screened if you're between the ages of 76 and 85.
How Colonoscopy Done
You will be lying on a table during the procedure when the doctor inserts a colonoscope into your colon and rectum via your anus. Your large intestine is inflated with air using the scope so you can see more clearly. The doctor can inspect your large intestine by using the camera to send a video image to a screen.
Is Colonoscopy Safe?
The operation of a colonoscopy is generally risk-free. However, the surgery itself and the sedative utilized both include inherent hazards, as with any medical operation. After the colonoscopy, if you experience severe abdominal discomfort, fainting, a fever, chills, or rectal bleeding, you should call your doctor.
Coloproctology Surgery Cost
Your specific colorectal treatment plan and your preferred hospital will affect the cost of your coloproctology procedure.
Following a consultation with one of the knowledgeable proctologists, you will obtain an official estimate price for your surgery. This written estimate is valid for 2 months on your colorectal operation.
All of the major medical insurance accept coloproctology surgery. Most medical insurance plans include coverage for colorectal surgery. Before having any operation, doctors encourage you to get formal authorization from your insurance company.
If you choose to pay for your surgery yourself, many surgeons offer a variety of financing options. Some of them provide financing with 0% interest, no down payment, and manageable monthly payments so you may begin treatment immediately.
Coloproctology treats conditions affecting the colon, rectum, and anus that are both benign and malignant. The invention of minimally invasive methods for colorectal resections and the use of stenting for patients with obstructions are two significant recent advancements in the surgical treatment of colorectal cancer. The implementation of extensive screening seeks to identify the illness earlier. The advancements in surgery for this disease have been complemented by advancements in radiotherapy and chemotherapy. Treatment for benign diseases such diverticular disease, hemorrhoids, and anal fissures has also changed, with a move toward less invasive surgical methods.