Coloproctologist - who is he? Coloproctologist and proctologist: what is the difference?

The rectum is the terminal part of the distal segment of the large intestine, which has a non-curved shape and closes with the anus. The rectum consists of the anal canal and the pelvic region and is adjacent to the organs of the genitourinary and reproductive systems . In women, this is the body of the uterus and the posterior projection of the vaginal tract; in men, it is the testes, prostate, ureters and bladder. Remains of undigested food, substances that are not absorbed by the mucous membranes of the small intestine, bacteria and their rotting products, salts, and bile components enter the rectum. The formation of feces occurs under the influence of digestive juice, which contains a large amount of mucous secretion.

Rectum

A proctologist treats diseases of the rectum. If there are suspicions of pathologies of the large intestine, an examination and consultation with a coloproctologist will be required. Statistics on rectal diseases today are disappointing: almost 65% of patients seek medical help when the disease reaches an advanced stage and surgical intervention is required for a further favorable prognosis. Doctors consider the psychological factor to be the main reason for late diagnosis: many patients experience discomfort and are embarrassed to contact a specialist in this profile. Proctologists believe that the solution to the problem is obtaining maximum information about why an examination by a given doctor is needed and what consequences delaying treatment can lead to.

How does an appointment with a proctologist go?

How to prepare for an appointment with a proctologist and how is the examination performed?

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City Clinical Hospital No. 31 » Publications » Preparing for an appointment with a proctologist

Preparing for an appointment with a proctologist

HOW IS AN APPOINTMENT WITH A PROCTOLOGIST AND HOW TO PREPARE FOR IT?

Proctological diseases are considered to be delicate problems, so many patients are embarrassed to see a proctologist. While the disease progresses, self-medication does not bring relief. We invite you to familiarize yourself with how the examination is carried out in the proctology department of City Clinical Hospital No. 31. We consider this information necessary for review in order to make your visit to the proctologist as comfortable as possible for you.

An appointment with a proctologist includes a conversation with the patient, during which complaints and medical history are clarified.

The doctor will ask you several questions about the symptoms and duration of the disease, previous treatment, chronic diseases, surgeries, if any. It is very important to bring with you to your appointment the results of all previous examinations by a proctologist (if this is not your first time visiting a doctor), extracts from your most recent hospitalizations, results of instrumental studies (sigmoidoscopy, colonoscopy), as well as ultrasound and tests. A lot depends on your openness and attentiveness, because the doctor will make a preliminary diagnosis at this stage.

After the conversation, the proctologist will conduct a primary examination: external examination, palpation of the perianal area and digital examination of the rectum.

PRELIMINARY PREPARATION FOR A PROCTOLOGIST EXAMINATION

In order for the appointment to be as informative as possible, the patient needs to properly prepare for it:

— it is recommended to exclude gas-forming foods (milk, bread, fruits and fresh vegetables, carbonated drinks) from your diet per day,

- the evening before and the morning of the appointment, a light dinner and breakfast are recommended, respectively, for example, an omelet or yogurt,

— the evening before and the morning of the doctor’s visit, you need to cleanse your intestines. To do this, you can use a regular 1.5 liter water enema. However, this method is currently considered obsolete, although its effectiveness when used correctly is very high. An alternative to a water enema is colon cleansing with Microlax microenema. It is necessary to use two microenemas in the evening and one in the morning three hours before the proctologist examination.

Such a thorough procedure for preparing for an appointment with a proctologist will allow you not to doubt the cleanliness of your intestines and not be embarrassed, and the doctor will conduct an examination and make a diagnosis as competently as possible.

The proctologist examines, palpates the perianal area and digitally examines the rectum with the patient in the left lateral position. To ensure that the examination is painless, the doctor uses a gel containing local anesthetics.

INSTRUMENTAL METHODS FOR DIAGNOSIS OF PROCTOLOGICAL DISEASES

In some cases, after a digital examination of the rectum, the proctologist completes the examination, but, more often, conducts an instrumental examination. It allows you to visually assess the condition of the intestinal mucosa, the degree of enlargement of hemorrhoids, the presence of polyps and tumors of the rectum and sigmoid colon.

These diagnostic methods include anoscopy and sigmoidoscopy. Additional preparation for these studies is not required if you have followed a diet and taken measures to cleanse the intestines, as in the above-described technique for preparing for an examination by a proctologist. Anoscopy and sigmoidoscopy are also performed with the patient positioned on the left side.

Anoscopy is performed using a special instrument that looks like a funnel-shaped tube with an illuminator - an anoscope. A sigmoidoscope looks like a long tube, which is also equipped with optics and illumination. Examination with a sigmoidoscope is called sigmoidoscopy. The only difference between these two methods is the depth of visualization: with anoscopy, a proctologist can assess the condition of the rectum to a depth of about 6-8 cm, with sigmoidoscopy - up to 40 cm. These studies are highly informative and painless in most cases.

Colonoscopy also refers to instrumental methods for diagnosing the condition of the large intestine, but is not performed at the initial appointment, as it requires more serious and lengthy preparation and the presence of strict indications. Colonoscopy refers to endoscopic diagnostics and allows you to evaluate the entire large intestine, detect inflammatory diseases, tumors, and congenital pathologies in it. Colonoscopy is performed using a flexible colonoscope and usually under intravenous sedation.

Who is a proctologist

A proctologist is a doctor who diagnoses, treats and prevents various ailments of the large intestine and perirectal area.

Reference . You can find out more about who a proctologist is here.

This specialist treats the following pathological conditions:

You can see a doctor either independently or through a therapist. In this case, the medical professional provides a consultation on how to prepare for an examination by a proctologist.

At the actual appointment, the doctor will make a diagnosis, determine the stage and nature of the disease, and select adequate treatment.

When they come to him

You should definitely and immediately visit a specialist’s office if the following symptoms appear:

1. Defecation disorders (diarrhea/ constipation ) - such problems have a negative impact on the intestines. Chronic constipation can cause injury to the intestinal walls, hemorrhoids, and anal fissures.
2. Pain during bowel movements.
3. Hemorrhoids.
4. The appearance of bloody, purulent or mucous impurities in the stool may indicate serious pathologies (fistula, polyp, oncology).

You should not ignore pain of various types in the anus, as this is fraught with the development of dangerous diseases that require immediate treatment.

Symptoms for which you need to contact a proctologist

Preventative examinations by a proctologist are recommended for people over 60 years of age, as well as for patients whose immediate blood relatives have had colorectal cancer or malignant tumors of the gastrointestinal tract. The remaining patients turn to this specialist only when painful symptoms occur or upon referral from a local physician if they suspect rectal pathology.

There are several dangerous signs that require consultation/examination by a specialist and are likely to indicate inflammatory, tumor or infectious processes in the anus. These include:

• pain when sitting, straining, lifting heavy objects, concentrated in the anus (may increase with coughing, hiccups and sneezing);
• painful bowel movements;
• changes in the color, smell and consistency of feces;
• dry and hard feces, looking like separate dense lumps;
• blood on the surface of the stool or inside the stool;
• pain during the passage of excrement through the rectum;
• mucus, pus, white spots in feces.

Blood in stool

Important! A dangerous sign is the appearance of black, unformed stool with a liquid consistency. This symptom may be a manifestation of hidden gastric or intestinal bleeding. The blood coagulates under the influence of the platelet mass and takes on a dark color, leaving the rectum in the form of a jelly-like thick mass. Hidden bleeding is a deadly condition in which it is necessary to urgently hospitalize the patient in the surgical hospital of the proctology department.

Proctologist's office

How to prepare for an examination

Any visit to the doctor requires compliance with certain preparation rules. When visiting specialist professionals, it is necessary to prepare more carefully.

The first thing you should do is take care of your diet before visiting a proctologist.

To do this, you must not eat foods that cause gas for several days before your visit to the hospital . These products include:

It is better to eat light, dietary dishes. As for drinks, it is better to give up soda and juices with pulp at this time.

Reference . It is recommended to take food at least 1.5 hours before visiting the doctor.

If you still experience bloating, you can take Espumisan before the visit.

Also, before visiting a proctologist, it is necessary to perform a bowel cleansing procedure. This can be done in two ways:

• mechanical rinsing using an enema;
• the use of laxatives.

If the patient experiences severe pain, then self-cleansing should not be done.

In this situation, the doctor will conduct an examination and prescribe painkillers and anti-inflammatory drugs. After the pain is relieved, the specialist will conduct the necessary tests.

Why an enema?

A cleansing enema before examination by a proctologist is necessary for an effective examination. A cleaned intestine will not complicate visual and hardware examinations, but on the contrary will contribute to better information content of the procedure.

The colon cleansing procedure is performed 3-4 hours before visiting the doctor. In this case, the patient will need to do 2 cleansing enemas, with a break between them of 45 minutes.

Reference. If taken in the morning, then the procedure should be performed in the evening before going to bed, if in the evening, then after the morning toilet.

To carry out the procedure, the following devices and materials are required:

1. Esmarch's irrigator.
2. Warm water - 36-37°C.
3. Oilcloth.
4. Soap.

After checking and preparing the devices, you can begin the procedure, which looks like this:

• lay down an oilcloth and lie on your left side, bending your legs;
• raise the mug by 1 - 1.5 m;
• Lubricate the tip with Vaseline;
• carefully insert the tip into the anus;
• within 5-10 minutes all the water will enter the intestines;
• If discomfort occurs, you can stroke your stomach clockwise.

Some time after the procedure, you will feel the urge to defecate. You need to wait about 10 minutes and then have a bowel movement.

Why do you need Microlax?

If a regular cleansing enema is not suitable for the patient, then a laxative can be used.

Reference . Experts often recommend Microlax microenemas.

Before using Microlax, before visiting a proctologist, you should read the drug and instructions for use.

This medication is a combination medication. Its effect is to soften stool and increase the amount of fluid in the intestines.

The drug has practically no contraindications, except for individual intolerance to the components.

How to use Microlax before an appointment with a proctologist? The product is easy to use.

In order to administer the drug you must:

1. Open the tube and press lightly so that the product lubricates the tip.
2. Insert the tip into the anus the entire length (for children under 3 years old - half).
3. Apply the product and remove the tip.

Cleansing the body will begin 15 minutes after administration of the product. Cleansing with Microlax must be carried out 3 hours before a visit to a specialist.

How to become a proctologist

To become a proctologist, you need:

1. Graduate from a university with a degree in General Medicine or Pediatrics.
2. Receive an accreditation sheet along with your diploma by passing tests, an exam and an interview with a special commission consisting of doctors of science and professors. This will give the right to work independently on an outpatient or outpatient basis.
3. It is mandatory to work for a year in a clinic or outpatient clinic, and then enter residency (2 years) in the specialty “Coloproctology”.

In the process of work, doctors are awarded qualification points confirming accreditation: for performing complex manipulations, participating in scientific and practical conferences and seminars, for publishing scientific articles, books, and defending a dissertation. Every 5 years these points are summed up and assessed by the accreditation commission. If you score a sufficient number of points, you can continue working in your specialty for the next five years. If there are not enough points, the doctor is deprived of the right to treat. Learn more about accreditation and internship cancellation.

The growth of professionalism, level of knowledge and experience of a doctor is usually reflected by qualification category . All categories are assigned by a qualification commission in the presence of the doctor himself, based on his written research work containing a description of skills and knowledge.

Assignment deadlines:

• more than 3 years of experience – second category;
• more than 7 years – first;
• more than 10 years - highest.

A doctor has the right not to qualify, but this will be a disadvantage for career growth.

Career and professional growth is also facilitated by scientific activity - writing candidate and doctoral dissertations, publications in medical journals, speaking at conferences and congresses.

What does a proctologist examine and how is the examination performed?

How is a proctologist examined? First, the proctologist listens to the patient’s complaints, asks questions and clarifies some important points, such as:

• frequency of bowel movements;
• the presence of a feeling of unemptied bowel;
• general health (whether there is a headache or weakness);
• the presence of blood, pus or mucus in the stool;
• nutritional features;
• possible independent treatment and in what ways;
• the presence of concomitant pathologies, especially gastrointestinal diseases.

Next, the examination itself is carried out. How is a proctologist examined by a proctologist for men and women?

The nurse accompanies the patient to the examination room and issues medical underwear for disposable use with an incision in the anus. The patient takes off clothes to the waist, lies on the couch on his side or stands in a knee-elbow position.

Next, the inspection is carried out according to the following scheme:

1. Visual examination allows you to assess the severity of the ongoing pathological process.
2. Finger examination - the doctor first treats the hands and anus with an anesthetic, which alleviates discomfort. This stage allows you to assess the condition of the muscles and detect formations. This is also necessary to determine possible contraindications for performing endoscopic examination.
3. Anoscopy is a procedure for thoroughly examining the rectum and anus using an anoscope.

The appearance of discomfort and pain in intimate places is a very delicate problem. Therefore, it is important to know how a proctologist examines you, as this will help you mentally prepare for a visit to the hospital.

Eventually

Coloproctologist – who is this and how important is the existence of such a specialist? Currently, a sedentary lifestyle combined with poor nutrition has become a real scourge of humanity. Therefore, it is not surprising that in recent years there has been a significant increase in requests to specialists in the field of coloproctology.

The main motive that should prompt periodic examinations by a coloproctologist is the prevention of diseases of the rectum and intestinal tract. After all, as you know, it is much easier to prevent the development of a disease than to deal with its many negative manifestations.

Among the general recommendations for people with coloproctological diseases, the following should be highlighted: following a diet, establishing a proper diet, avoiding overexertion in the form of excessive physical and mental stress and, of course, regular examination by a coloproctologist.

Examination and detection of hemorrhoids by a proctologist

How does a proctologist examine hemorrhoids and do you need to specially prepare for a visit to the doctor?

For any discomfort in the anus, patients usually seek help from a doctor. After all, discomfort of this kind most often indicates the development of hemorrhoids.

Before prescribing treatment, the proctologist (or coloproctologist) examines the patient and conducts additional hardware examination. If necessary, the doctor can provide a referral for consultation with other specialists.

Many people consider hemorrhoids to be a common disease that is easy to get rid of. However, ignoring the prescribed examination can lead to an error in diagnosis and incorrect therapy with complications.

Indications for visiting a doctor

Quite rarely, patients visit a proctologist for preventive purposes. This usually occurs when severe signs of illness and discomfort appear.

To prevent the progression of the disease and avoid possible complications, you should seek medical help if the following symptoms occur:

• Prolonged diarrhea, constipation, or alternation of both.
• Pain of varying intensity in the anal area and rectum, which can manifest itself in various conditions: during defecation, at rest, during prolonged sitting.
• Weakness of the intestine, its prolapse.
• Unpleasant sensations during and after defecation.
• Redness, itching, swelling, burning, rash in the perianal area.
• The presence of blood, mucus, pus in the stool, as well as pathological discharge from the anus.
• Bloating, feeling of heaviness, flatulence.
• Inflammatory phenomena.
• Protrusion of nodes with hemorrhoids from the anus.
• Tenesmus, sensation of a foreign body, incomplete emptying after defecation.
• Stomach ache.

If these signs occur, you should not delay it and consult a doctor as soon as possible for a proctological examination.

It is advisable for some categories of people to visit a proctologist for preventive purposes, due to the increased likelihood of diseases in this area.

These groups of people include:

• Pregnant women and women who have recently given birth - during this period, the first manifestations of diseases of the anorectal area, in particular hemorrhoids, often appear, or existing ones worsen. During the period of bearing a child, the examination procedure is carried out with extreme caution; some diagnostic methods are used only in exceptional cases.
• People with a sedentary lifestyle with prolonged sitting, as well as varying degrees of obesity.
• Senior and elderly people are recommended to undergo regular preventive examinations. This is especially true for women during menopause, since hormonal imbalance at this time contributes to the development of many diseases. According to indications, diagnostic procedures (colonoscopy, sigmoidoscopy) may be prescribed.
• Patients who have had diseases in this area and who have a chronic form of the disease are subject to regular proctological examinations.

How is hemorrhoids examined?

An appointment with a proctologist begins with a conversation. Next, the doctor conducts a digital examination. The patient lies on the couch on his left side. To make an accurate diagnosis, the specialist immediately performs anoscopy or rectoscopy.

Examination chair

Algorithm of patient actions:

1. Answer all the doctor's questions.
2. Undress from the waist down and go to the couch (chair).
3. Take the position suggested by the doctor.

Modern clinics have both male and female proctologists on their staff.

After consultation, the specialist will prescribe the necessary research methods

Examination is often embarrassing for women! Impressionable patients can safely make an appointment with the doctor to whom they can openly talk about their problem.

Examination rooms are equipped with changing areas enclosed by a screen. The examination is carried out in the same chair as in the office of a gynecologist or urologist, or on a couch. Shy patients are offered to use disposable underwear, which completely covers all intimate parts.

Patient position

A proctological examination is a very intimate procedure. The doctor places patients with severe hemorrhoids on the couch on their left side, after which they begin the examination. In most cases, the patient lies down in a regular gynecological chair and pulls his legs to his stomach. The doctor may also ask the patient to take a knee-elbow position.

Proctology clinics are equipped with special couches for convenience.

The average patient needs an appropriate mindset before consulting a doctor to cope with the feeling of awkwardness. Therefore, the initial examination is most often carried out on the couch.

With the help of an assistant, the doctor conducts a visual examination and a digital examination. For a more detailed examination, the specialist asks the patient to take a different position. Usually by this time the patient relaxes somewhat and calmly responds to the specialist’s requests.

External inspection

Visual examination of the perineum and anus includes:

1. studying the shape of the anus;
2. detection of sphincter gaping;
3. identification of scars, deformations, fistulas, irritation;
4. determination of the severity and size of hemorrhoids, their bleeding and the possibility of reduction into the anus without outside help.

The doctor assesses the degree of clinical symptoms of the disease, that is, determines the stage of hemorrhoids.

Using the probe

To assess the anal reflex, streak irritation of the skin of the perianal area is performed using a special probe. The specialist spreads the patient’s buttocks, examines the walls of the anus, determines the presence of cracks in the anal canal, as well as the severity of the internal nodes.

Finger examination

This type of diagnosis is decisive for proctological diseases

Carrying out a digital examination of the rectum, the proctologist determines:

• presence/absence of contractile function of the anal sphincter;
• the degree of pain the patient experienced during the examination;
• the presence of scars and polyps on the mucous membrane of the anal canal.

Since the hemorrhoidal tissue in the anal canal is very soft and elastic, during a digital examination, hemorrhoids and defects in the form of polyps or scars are reduced and simply not detected. Displacement of the mucous membrane during palpation indicates the presence of these defects.

Determining the degree of node loss

The stage of node prolapse is clearly determined when the patient strains. To assess the actual size of the nodes, the patient is asked to sit on a chair and strain very hard. At this point, you can find out whether he will be able to insert them into the anus on his own.

It is this indicator that often serves as the basis for choosing a minimally invasive intervention technique in the treatment of hemorrhoids.

Even during anoscopy it is not always possible to determine the size of the nodes. When held in the anus, they appear much smaller.

What kind of doctor is a coloproctologist and what does he treat?

A coloproctologist is a general practitioner who can perform the functions of a therapist, focusing exclusively on diagnostic measures aimed at identifying diseases that affect the mucous membrane and denser tissues of the rectum of the upper segments of the digestive system.

This specialist also treats pathologies using medications, tablet and injection forms. A separate category of coloproctologists deals only with surgical treatment of diseases of the corresponding localization.

The area of ​​responsibility of a doctor of this specialization includes the treatment of the following pathologies of the gastrointestinal tract and lower parts of the digestive system:

• chronic and acute hemorrhoids with dilation of the venous nodes of the anus of varying degrees of severity and width, with bleeding or without destruction of the walls of capillary vessels;
• various kinds of foreign neoplasms of benign etiology in the form of cysts, polyps, condylomas and other epithelial growths;
• anal fissures formed under the influence of too hard stool, the patient’s hereditary predisposition, or as a result of mechanical damage to the rectum caused by certain circumstances;
• inflammatory processes that have arisen due to a bacterial, viral or fungal infection entering the patient’s body, causing short-term or long-term intestinal upset;
• acquired or congenital defects and anomalies of internal organs located in the anal area;
• dysbacteriosis and candidiasis, regardless of their form;
• parasitic infections of the gastrointestinal tract (in this case we are talking about both helminthiasis, when round or tapeworms are found in the patient’s intestines, and about microorganisms accustomed to leading a parasitic lifestyle);
• neurological syndrome, when, due to dysfunction of the nerve endings located in the anal ring, a false sensation of pain occurs (manifests in an acute or aching form);
• surgical and medicinal relief of fistulas, purulent abscesses and abscesses that appear in the cavity of the gastrointestinal tract;
• complete or partial prolapse of the rectum;
• perforated ulcer with complete destruction of the epithelial layer of the diseased organ of the digestive system;
• removal of foreign bodies that have entered the anal cavity as a result of accidents, falls from great heights or for other reasons;
• cancerous tumors of malignant origin at all stages and stages of their development.

A coloproctologist surgeon is involved in the general course of treatment only in extreme cases, when all other methods of influencing the source of the disease have been exhausted and it is impossible to restore the stable functioning of the digestive system in the affected area with traditional medications.

If the hospital does not have a coloproctologist as a staff member, then in this case, a proctologist or a general surgeon who has excellent knowledge in the field of human anatomy and is able to perform surgical treatment for a speedy recovery of the patient is involved in the patient’s treatment.

Additional Research

If necessary, patients with hemorrhoids are prescribed x-ray, endoscopic, and morphological studies.

Before a planned operation, the patient must undergo blood tests for biochemistry, coagulation, sugar, Rh factor, serum hepatitis and HIV infection. If concomitant diseases are identified during the examination, the patient is recommended to see other specialists.

Sigmoidoscopy is recommended for all patients with hemorrhoids. But this examination method does not replace the examination by a proctologist, so as not to miss pathologies of the anal canal.

Responsibilities of a proctologist

The main responsibilities of a proctologist are:

• Emergency and planned care for patients. Outpatient (consultative) appointment.
• Inpatient management of patients in the preoperative and postoperative period.
• Carrying out anoscopy, retroromanoscopy, colonoscopy, laser manipulations.
• Minimally invasive medical procedures.
• Working as part of a medical council.
• Scheduled medical examination and preventive examinations.
• Registration of sick leave, documents for medical examination and other documentation.

How to prepare for an examination by a proctologist

For an effective examination by a doctor, the patient must be prepared.

A few hours before your appointment, you need to clear your intestines of feces in one of two ways:

• make a microenema with the drug "Microlax";
• the night before, do a cleansing enema using 1 liter of boiled water and cooled to room temperature.

Patients with severe pain in the anus can be examined by a proctologist without prior preparation.

THERE ARE CONTRAINDICATIONS CONSULTATION WITH YOUR DOCTOR IS REQUIRED

Author of the article Alexey Alexandrovich Egorov, proctologist

Where to get training

In addition to higher education, there are a number of short-term training on the market, usually lasting from a week to a year.
The Interregional Academy of Additional Professional Education (MADPO) teaches in the specialization “Coloproctology” and issues diplomas and certificates.

The Medical University of Innovation and Development invites you to take distance courses for retraining or advanced training in the field of Coloproctology to obtain a diploma or state certificate. Training lasts from 16 to 2700 hours, depending on the program and your level of training.

How to prepare for an appointment with a proctologist and how is the examination performed?

Do you need to prepare for an appointment with a proctologist? When going to see a doctor, in some situations, preliminary preparation for the examination is important, for example, you need to prepare for an appointment with a proctologist. A proctologist deals with problems related to the rectum and organs adjacent to it.

People are afraid of this doctor for many reasons: some are afraid of pain, others are simply embarrassed to show their private parts. But in any case, if there is pain in the anus, bleeding or other discomfort, you cannot do without an examination by a proctologist.

How to prepare for an appointment with a proctologist so that everything goes smoothly?

In what cases should you contact a proctologist?

Those who have encountered unpleasant symptoms that require a visit to this specialist want to know how an appointment with a proctologist goes. Indeed, most diseases associated with the colon are easier to detect at the initial stage and treated with conservative methods than to wait until the moment when only radical therapy, that is, surgery, is possible. So, you should consult a proctologist if you have chronic constipation or diarrhea. These symptoms indicate problems in the functioning of the digestive system. Constant stool disturbances injure the intestines and irritate its mucous membrane. This can lead to hemorrhoids and anal fissures. The doctor will check for these disorders, examine the intestinal mucosa and prescribe appropriate treatment.

Rectal bleeding is also a very alarming symptom, which is a reason to urgently visit a doctor. This may indicate an exacerbation of hemorrhoids, fistulas, polyps and more serious formations - tumors. Inflammation and prolapse of hemorrhoids are possible. This condition is characterized by a sensation of a foreign body in the anus, burning, itching and severe pain. Often when nodes are damaged, heavy bleeding occurs. Pain during bowel movements may indicate anal fissures or sphincter muscle spasm. These disorders require special treatment. Ignoring the pathology is dangerous due to the development of inflammatory and purulent processes in the surrounding tissues. In addition, preventive examinations are recommended and should be completed by all patients over 40 years of age.

Preliminary actions

When planning an appointment with this specialist, you will have to prepare in advance. To prepare for an appointment with a proctologist, first of all you will have to go on a diet for several days. Usually, 1-2 days of not eating foods that cause gas are enough. These products include:

1. Carbonated drinks.
2. White cabbage, cooked in any form.
3. Grape.
4. Apples.
5. Dough products.

If even after this you feel bloated, then take 3-4 tablets of crushed activated carbon. If your visit to the doctor is scheduled for the morning, then have a light dinner in the evening, such as broth or dry biscuits. Immediately before your appointment, if you really want to, you can eat a boiled egg or a sandwich with cheese. But it is best to drink only tea.

Since going to the proctologist is a very exciting event, it is worth preparing yourself psychologically. After all, most people regard a visit to such a doctor as something terrible. This delays the trip to the proctologist. And this has a negative impact on health.

In order not to worry too much, choose a doctor yourself, following the advice of friends or general recommendations about this specialist. If the patient is a woman, which makes it difficult to seek help from a male doctor, you can visit the office of a female proctologist.

Conversation with a doctor

Surely, if you go to a proctologist, something is bothering you, so in order for your conversation to give an accurate picture of what is happening, you should prepare for it in advance. Below is a list of possible questions from the doctor, the answers to which you should prepare in advance:

1. What complaints did you come with? Most often this is pain, burning or other discomfort in the anus, bleeding, a feeling of incomplete emptying, heaviness and pain in the lower abdomen, etc. You must substantiate each of your complaints. If it is pain, then it is worth describing it, telling when it appears, where exactly it is localized, the same with itching. When bleeding, it is worth describing the quantity, quality and color of the blood.
2. How often do you have a bowel movement? This question may reveal your tendency to constipation or diarrhea.
3. Is there impurities in the stool in the form of blood, pus or mucus? Be sure to pay attention to this in advance.
4. What are the features of your diet? When answering this question, you should not describe your daily diet, just list the foods and dishes that you eat most often. This will be enough for the doctor to adjust your diet.
5. Have you treated yourself and how? You can make a list in advance of the medications you took before going to the doctor.
6. Presence of concomitant diseases? Most likely, with proctological diseases there are also gastrointestinal disorders. Be sure to tell your doctor about them.

If you have prepared in advance for the survey, examination and research, then you do not need to worry about anything.

Objectives of the study

Nowadays, thanks to many advances in the field of medicine, it is possible to diagnose the disease at the development stage. Special devices and equipment that allow you to see the problem from inside the body provide enormous help.

Thus, a proctologist, using rectoscopy, can at an early stage diagnose diseases such as:

• haemorrhoids;
• inflammation of the large intestine;
• intestinal obstruction;
• peptic ulcer;
• polyps;
• malignant tumors;
• anal fissures;
• mucosal injuries.

The purpose of such diagnostics is to identify the disease at an early stage for successful treatment of the disease. After all, an advanced disease is much more difficult to treat, and if it has entered the chronic stage, it will take years to get rid of the pathology. An examination by a proctologist, first of all, can exclude malignant formations in the rectal area.

What does coloproctology study?

The list of diseases that are at the attention of specialists in this field is quite extensive. Here is just a small part of this list:

• any trauma to the rectum;
• prostatitis;
• proctitis;
• haemorrhoids;
• anal itching;
• tumors in the colon;
• colitis;
• bowel prolapse;
• parasitic diseases of the rectum and large intestine;
• epithelial coccygeal duct.

Some people may be confused by certain diseases when looking at this list. For example, does prostatitis belong to the field of proctology, since a urologist deals with diagnosis and treatment? In fact, there is no mistake here. The prostate gland of a man is located behind the thin mucosa of the large intestine, and often inflammation of the prostate has a direct connection with proctological diseases. Thus, many patients forget about the cause of prostatitis, such as hemorrhoids or frequent constipation. The constant accumulation of feces with a high content of E. coli through the thin mucosa puts pressure on the genitourinary organs, impairs their functioning, not to mention pathogens that also find “weak” areas and try to penetrate adjacent organs.

The therapy that will be adopted in this case will be truly effective, because it will take into account the requirements, requests and knowledge of the entire pelvic system, and not individual organs.

It turns out that such diseases should be treated by two specialists from different branches of medicine? Yes, and this decision will be correct. Each specialist must examine the patient according to the accepted diagnostic scheme, and then familiarize himself with the results and the opinion received from another doctor.

When to contact a coloproctologist

It is very important to know the symptoms, which should be the reason for immediate contact with a coloproctologist. If the following phenomena occur, the patient should consult a doctor:

1. Any defecation disorder. It can be either constipation or diarrhea. If the coloproctologist deems it necessary, he will refer the patient to another specialist for further study of the clinical picture, for example, an infectious disease specialist.
2. Pain during defecation. This is the most common reason for visiting a coloproctologist. There can be many reasons for this, and diagnosing a patient, especially the primary one, will take more than one day.
3. Blood and mucus discharge from the anus. This sign cannot be ignored, because it can be a symptom of serious diseases, including oncological processes in the rectum.
4. Itching in the rectum. Most often this happens when infected with parasites, but it is quite likely that other diseases will develop.
5. Feeling of incomplete bowel movement. If a person does not completely empty the rectal area, then the particles of feces that will be there can become a source of inflammation not only in this area, but also in adjacent organs.
6. Prolapse of hemorrhoidal node. As a rule, this symptom concerns those people who constantly visit the coloproctologist’s office and pose the danger of inattention to the problems of the anus.

How is the examination carried out?

An examination by a proctologist is usually carried out according to the following scheme:

1. Initially, the doctor talks with the patient.
2. Next, palpation of the outer and inner parts of the rectum is performed. The patient lies sideways on the couch. The examination is carried out carefully, using special anesthetic ointments or gels.
3. Anoscopy – using a special instrument, you can view the inside of the rectum at a depth of up to 10 cm.
4. Rectoscopy – a deep examination is performed using a rectoscope.

What diseases does a proctologist treat in women?

Of course, the gastrointestinal tract in women and men is structured the same. However, in many cases, the causes of the disease in the fair sex may be different. And given the fact that each organism is individual, it is important to identify the pathogenetic link and act on it. Let's figure out what a proctologist treats for women:

1. Haemorrhoids. A fairly common disease, especially among women who have given birth and those who lead a sedentary lifestyle. The disease is characterized by varicose veins of the rectum, their thrombosis and inflammation. Hemorrhoids can be external and internal. If not treated in a timely manner, hemorrhoids can extend beyond the anus, become infected and necrotize;
2. Anal fissure. The disease is characterized by a violation of the integrity of the walls of the anus, which most often occurs after childbirth. Anal fissures bring a lot of discomfort, especially during bowel movements. In addition, cracks often become infected, inflamed and bleed;
3. Tumor-like formations of the colon. These can be benign tumors: polyps, cysts and malignant ones: colorectal cancer. The proctologist in these cases is a related specialist who is involved in diagnosis and treatment together with other doctors;
4. Constipation, acute and chronic. Women most often experience constipation during pregnancy or after childbirth. A proctologist will help you find out the cause of unstable stools and prescribe adequate treatment. It should be remembered that not all laxatives are safe. In some cases, the cause of constipation may be other pathologies that need to be eliminated;
5. Rectovaginal fistulas. The most common pathology among women who have given birth. Fistulas can form after childbirth and cause a lot of inconvenience. Therefore, timely diagnosis and treatment in this case plays an important role;
6. Ulcerative colitis and Crohn's disease. Damage to the colon mucosa;
7. Diverticula. This pathology is one of the causes of unstable stool and, if not treated in a timely manner, can perforate the intestines, causing a terrible complication - peritonitis;
8. Incontinence of gases and feces. A common pathology among women that can occur after childbirth, as a result of injury, surgery;
9. Rectal prolapse;
10. Abnormal development of the rectum;
11. Injuries of the colon and some other pathologies.

A proctologist acts as a related specialist in the treatment of infectious pathologies, oncology and intestinal obstruction.

Types of diagnostics

Sigmoidoscopy (rectoscopy) involves examining the mucous membrane of the rectum and sigmoid colon using a rectoscope. This procedure is recommended for all those who seek help from a proctologist as a test for diagnosing and detecting cancer. The patient lies on his side with his knees pressed to his stomach. Most people tolerate this study well without severe pain.

1. The day before the test, stop eating vegetables and fruits; ideally, spend the whole day on liquids.
2. On the day of the examination, if you have an appointment in the evening, starting from 14-15 hours, do cleansing enemas using an Esmarch mug. And so 3-4 enemas until 17-18 hours, the amount of water per procedure should be 1-1.5 liters. Cleansing enemas should be stopped 2 hours before your doctor’s appointment.
3. The drug Microlax is also used to cleanse the rectal mucosa. It is a tube with gel and a tip for convenient insertion into the rectum. After administration of the drug, a person feels the urge to defecate. Discuss methods of using Microlax with your doctor in advance.

Colonoscopy is an endoscopic examination using a colonoscope equipped with a mini-camera, and everything that happens is displayed on a computer monitor. Colonoscopy makes it possible to study the contents of the large intestine with deep penetration, right down to the thermal part of the small intestine. The duration of the procedure is from 15 to 40 minutes, in some cases anesthesia is used.

Before the procedure, you can drink Fortrans or Lavacol powders dissolved in water; they are intended to cleanse the colon. The regimen for taking these medications should be discussed with your doctor. Bowel cleansing is necessary before the examination, since feces will make it difficult to see during visual and endoscopic examination, and this, in turn, will lead to an incorrect diagnosis. Before preparing for the examination, the patient should talk with his attending physician; the doctor will determine how and how many times to use cleansing enemas or drink appropriate laxatives based on your condition and individual qualities.

Since you should have enough time to prepare for the examination, you will have to take a day off from work or give up all household chores. The day before going to the doctor should be reserved only for you. If all the rules of bowel cleansing and psychological preparation are followed, then the examination will go smoothly and painlessly.