What Is a Proctologist?

Proctologists are specialized surgeons who are trained to treat conditions that involve the colon and rectum. The colon is also known as the large intestine, and the rectum is the last section of the large intestine closest to the anus.

Proctologists are knowledgeable in surgical and non-surgical treatment of colon and rectal conditions. They can perform endoscopies to examine intestines, diagnose and manage conditions in the intestines, and conduct surgeries to treat those conditions. Some conditions proctologists treat include hemorrhoids, infections, inflammatory bowel disease, anal conditions, and colon and rectal cancer.  

Proctologists are now more commonly referred to as colon and rectal surgeons or colorectal surgeons. The name change was a result of the American Proctologic Society changing its name to the American Society of Colon and Rectal Surgeons in 1973 to better communicate what these doctors do.

What Does a Proctologist Do?

Colon and rectal surgeons have the skills and knowledge of the intestinal system to manage a person through the entire journey of an intestinal disease—from diagnosis, to treatment and surgery, to post-surgery care. They also perform routine screenings and check-ups to verify intestinal health and prevent colon and rectal diseases. 

What Conditions Does a Proctologist Diagnose and Treat?

A colon and rectal surgeon can diagnose and treat cancer that affects the large intestine or rectum. They can also help manage constipation and incontinence (the inability to control the passage of gas or stool). Other common conditions a colon and rectal surgeon can treat are:

• Polyps: These are abnormal growths in the walls of your large intestine or rectum. Removal of these polyps reduces the risk of colon and rectal cancer
• Inflammatory bowel disease (IBD): Two types of IBD are ulcerative colitis and Crohn's disease. They cause inflammation and damage to your intestines.
• Diverticulitis: This is a disease that causes small bulges or sacs on the walls of the large intestine, which can cause abdominal pain and infection.
• Pelvic floor abnormalities: These are a group of diseases that includes rectocele (a weakening of the tissue between the rectum and vagina) and levator syndrome (when muscles near the anus spasm and cause pain). These conditions cause pelvic pain and affect the way people experience bowel movements.
• Hemorrhoids: These are enlarged and painful blood vessels in and around your anus and rectum.
• Abscess and fistula: These are infections that can happen if glands near the anus get clogged. An abscess is a pocket of pus. A fistula is an infection of a tube connecting the inside of your anus to the skin.
• Sexually transmitted infections (STIs): There could be complications of STIs like human papillomavirus and anal warts.
  

Procedures a Proctologist Performs

Colon and rectal surgeons can perform a variety of procedures for treatment and diagnosis. These range from minimally invasive procedures to major surgeries.

Endoscopies

An endoscopy is a procedure in which a doctor uses a small camera called an endoscope to examine portions of the intestines and other parts of the gastrointestinal tract. Endoscopies are performed to make a diagnosis or to do a routine check-up on a condition. The imaging procedure is sometimes used during surgeries.

There are several types of endoscopies, each one named differently depending on the areas of the body they examine. Colon and rectal surgeons are typically trained in colonoscopy (colon, rectum and anus) and sigmoidoscopy (rectum and lower part of large intestine).

Surgeries 

Colon and rectal surgeons can perform surgeries to treat many diseases including colon and rectal cancer, hemorrhoids, and polyps.

One type of surgery they perform is resection. Resection surgery involves the removal of a portion or the entirety of an intestine. This might need to be done because of colon, rectal, or anal cancer or because of complications related to IBD or diverticulitis. In some cases, surgical resections result in surgical placement of an ostomy bag, a pouch that lies outside your body and is used to collect stool.

Colon and rectal surgeons can also perform a polypectomy. This procedure involves the removal of polyps in the walls of the large intestine or rectum as measure to prevent cancer. The surgeons can also remove hemorrhoids in a procedure known as a hemorrhoidectomy.

To treat an abscess, the doctor can make an incision to surgically drain the abscess. To treat a fistula, the surgeons can perform a fistulomy. This procedure involves opening the fistula to allow it to heal.

Digital Rectal Exams

Digital rectal exams can be performed as a diagnostic test where a medical provider inserts a gloved and lubricated finger into the anus to examine for unusual growths or lumps. This exam can be used to help diagnose anal cancer and prostate cancer in men.

Going to the Proctologist

Because colorectal surgeons are considered specialists, a referral from your primary care physician may be required to get an appointment. If you have symptoms related to conditions of the colon and rectum, visit your primary healthcare provider. Symptoms may include:

• Abdominal pain or cramping
• Continuing diarrhea 
• Chronic constipation 
• Blood in your stool occurring regularly
• Drainage from the skin around the anus 
• Infections around the anus 
• Burning and skin irritation in and around the anus
  

What to Expect When Visiting a Proctologist

During your first visit, your colon and rectal surgeon may review your medical history, including the symptoms that had you make the appointment, and ask about your daily diet. The provider may also perform a physical exam, which may include a digital rectal exam to check for any abnormal growths or lumps.

If necessary, the doctor might ask you to get lab tests that require the need for blood and stool samples.

How to Prepare for a Visit to a Proctologist

For a standard visit to a colon and rectal surgeon you should have your medical records on hand. Check with your health plan to see if the specialist visit is covered and to find out whether you need a referral from a primary care provider. If you need the referral, make sure to bring it to the appointment. If you are going in for a procedure, see if your health plan requires prior authorization (a sign-off from the company that approves coverage) before undergoing the procedure.

If you are going in for an endoscopy, you will have to clear out your bowels beforehand following a pre-approved plan provided by your doctor. This bowel prep is required for your doctor to clearly examine your intestines. The prep will likely include changing your diet for a couple of days prior to the appointment and taking laxatives to clear out stool.

A Quick Review

Proctologist is an older term. Today, the providers are referred to as colon and rectal surgeons. Colon and rectal surgeons are specialists in diagnosing, managing, and treating conditions that affect the large intestine and rectum, like colon cancer, inflammatory bowel diseases, and hemorrhoids. They can address these conditions with procedures like endoscopies and different types of surgical interventions. If you are experiencing symptoms like abdominal pain, cramping, and blood in your stool, you should visit your primary healthcare provider. After their examination, they may refer you to a colon and rectal surgeon for further examination.