Proctologist. What does this specialist do, what research does he do, what diseases does he treat? What does a proctologist treat?

The profession of a proctologist is as honorable and respected as any other medical specialty. The specificity of this area is that in addition to providing qualified care, the doctor must treat each patient as delicately as possible, because the object of treatment is an organ whose diseases are not usually brought up for public discussion.

So what does a proctologist treat? Let's take a closer look at what this branch of medicine does, and in what cases it is necessary to seek help from a proctologist.

Proctology (coloproctology) is a branch of clinical medicine that studies diseases of the large intestine (rectum and colon), anus and anorectal area. Accordingly, the proctologist diagnoses, treats and prevents pathological conditions lower section intestines and anal area. Doctors of this specialization carry out diagnostic measures using modern endoscopic techniques and carry out not only drug treatment, but also perform a variety of surgical interventions.

Today, it is more correct to call this branch of medicine coloproctology, since this definition most fully reflects the scope of activity of proctologists. And if previously narrow specialists dealt only with pathologies of the rectum, now their competence includes all parts of the large intestine, including the rectum and colon.

The profession requires a proctologist to have extensive knowledge in medicine; he must not only identify diseases related to proctology, but also have knowledge in the field of urology, gynecology, venereology, oncology, and at the same time find a special psychological approach to each patient. Most often, the patients of doctors of this profile are people over 45 years of age, since such common pathologies as hemorrhoids and colon cancer are rarely found in young people.

In proctology centers on the bases of large medical institutions complex reconstructive surgical operations are performed, requiring the use of the most advanced and innovative equipment. At the same time, modern minimally invasive non-surgical techniques, such as laser treatment, radiofrequency surgery, sclerotherapy and others, have become widespread in the treatment of diseases of this profile.

Let's take a closer look at the list of diseases that a proctologist encounters in the course of his work.

With congenital anatomical lesions of the rectum, children may experience incontinence of gases and feces; the same symptoms, but only acquired, occur in older people. Women often experience postpartum sphincter insufficiency caused by perineal tears. These pathological conditions require competent and timely surgical treatment.

The most common conditions are anal fissures And inflammatory phenomena, related . They are accompanied pain syndrome, bleeding, swelling and itching in the anorectal area. These manifestations can be successfully treated with conservative by medication. In advanced cases, in the last stages of hemorrhoids, when prolapse of nodes is noted and complications develop, proctologists are forced to resort to surgery or minimally invasive treatment methods.

Complications of hemorrhoids include thrombosis of strangulated nodes, anal fistula, and paraproctitis. Chronic inflammatory processes may develop: enterocolitis, colitis of various etiologies. In this case, disturbances in intestinal motility, swelling and damage to the mucous membrane of the colon are observed.

There are also neurological lesions, manifested in severe pain in the coccyx area. They intensify with straining, walking and spread to bottom part abdomen and perineum. Such persistent pain can last for years and lead to physical exhaustion sick.

The greatest danger is posed by malignant tumors of the large intestine. In these cases it is important timely diagnosis and detection of neoplasms on early stages. In most cases, anal canal cancer is asymptomatic in the early stages, which is why preventive examinations by a proctologist are so important, allowing a correct diagnosis to be made in a timely manner.

In what cases is examination necessary?

For many patients, a visit to a proctologist is associated with this. It occupies a leading place in the structure of these diseases and can be diagnosed in an uncomplicated form on initial stages or appear different, dangerous complications in advanced cases. Many patients delay visiting a doctor until the last minute, hoping for traditional methods of treatment and refusing examination due to a false sense of shame.

The result of such an unreasonable attitude towards one’s own health can be life-threatening complications, including malignant tumors. To prevent this from happening, it is necessary to pay attention in time to the appearance of unfavorable symptoms and visit a doctor if the following manifestations occur:

• Persistent chronic constipation alternating with diarrhea.
• Pain in the anus, aggravated by prolonged sitting, during or after bowel movements.
• Appearance in feces ah pathological impurities in the form of blood, pus or mucus.
• Bleeding from the anus.
• Inflammation, itching, hyperemia or swelling of the perianal area.
• Feeling incomplete emptying intestines and foreign body in the rectum.
• Inflamed hemorrhoids in the anus.
• Pustular rashes in the anal area.
• Prolapse of hemorrhoids or part of the rectum.
• Constant abdominal pain, bloating,...

The appearance of at least one of these symptoms indicates that it is necessary to undergo examination by a proctologist.

During the appointment, the specialist will conduct an examination and listen to the patient’s complaints. For staging correct diagnosis a number of examinations will be required. Initially apply the most simple methods. Using palpation, the doctor can examine the intestines. To do this, the patient is placed on the couch and fingers through abdominal wall palpate the intestine.

Then the specialist conducts finger examination rectum through the anus. Thus, the anal canal and the parts of the rectum closest to it are palpated. This allows you to identify damage to its walls or pathological formations. Instrumental methods are used to examine other parts of the intestine.

Many patients are unreasonably afraid of such manipulations, considering them very painful. This is not true. Examinations are carried out using special devices - an anoscope or sigmoidoscope, which allow you to visually examine the inner surface of the rectum and see pathological changes. In many cases, a colonoscopy is indicated. Let's take a closer look at how these diagnostic measures are carried out:

. Diagnosis is carried out using a special device - an anoscope, designed for visual inspection of the inner surface of the rectum. An anoscope is a hollow tube, inside of which there is a fiber-optic adapter with a lighting device.

After a digital rectal examination, the patient is placed on his side with his knees pulled up to his stomach and the device is carefully inserted into the anus to a depth of 14 cm. In addition to examination, during the manipulation you can take a smear or material for a biopsy. When contacting a proctologist, this examination method is considered mandatory.

The examination does not take much time, but is accompanied by some discomfort. If severe pain occurs, you must inform your doctor. In such situations, painkillers will be used. A contraindication to such a study may be acute inflammatory processes in the anus (thrombosis of hemorrhoids, acute paraproctitis).

Sigmoidoscopy. It is the most accurate diagnostic method for examining the sigmoid and rectum. Using a special device - a sigmoidoscope, the doctor can visually examine the intestinal mucosa to a depth of up to 40 cm from anus.

The device is a fiber optic tube with lighting at the end. The procedure is performed in the knee-elbow position, which the patient occupies on a medical chair. This position is considered the most convenient for examination, as it facilitates the passage of the device from the rectum to the sigmoid colon.

During the procedure, the doctor assesses the condition of the mucous membrane, its tone and motor functions, the presence of pathological changes. The procedure is absolutely safe, and when performed by an experienced doctor, it is painless and is carried out in most cases without anesthesia.

Colonoscopy. Endoscopic method, which is considered the most informative for the early diagnosis of colon tumors, Crohn's disease and other diseases. It allows you to examine the large intestine along almost its entire length. In addition, during the procedure, additional therapeutic manipulations can be performed: removing a small benign tumor, stop bleeding, remove foreign body or take a piece of tissue for histological analysis.

The procedure is carried out using a special device - a colonoscope, under local anesthesia. IN severe cases colonoscopy is done under general anesthesia. The procedure is quite complex, requiring attention and experience from the doctor. The colonoscope is inserted into the anus and begins to move forward, while simultaneously supplying air to straighten the lumens of the intestine.

The patient may experience painful sensations when the device passes through bends intestinal loops, besides, when air is supplied, a feeling arises. At the end of the procedure, the air introduced into the intestine is sucked out by an endoscope.

During diagnostic measures the doctor prescribes laboratory tests, including blood and stool tests (for occult blood, helminths). In many cases, they do a coprogram, tests for candidiasis, fungal infections, papillomavirus, and tumor markers.

If you suspect serious illnesses apply modern methods hardware diagnostics. The patient is prescribed an x-ray with contrast agent, ultrasound, computed tomography, colon hydrotherapy, intestinal ozonation.

How to prepare for an appointment with a proctologist?

Before going to see a specialist, you need to properly prepare for the examination and cleanse the intestines. You can do this in several ways:

1. Taking laxatives. Fortrans is best suited for these purposes. Taking it according to a certain scheme allows you to effectively cleanse all parts of the intestines. The product is well tolerated and does not affect general health, cleansing can be done at home. Fortans does not cause cramps or abdominal pain and is ideal for patients with concomitant diseases gallbladder and liver.
2. Preparation The procedure is done in the evening, the day before the examination and in the morning, 2-3 hours before the appointment. For an enema, use an Esmarch mug, which is filled with warm boiled water in the amount of one and a half liters. It is more convenient to do the procedure with the help of loved ones. The mug must be lifted up and held in this position, or secured to something. The patient should lie on his side with his legs pulled up to his stomach. Lubricate the enema tip with Vaseline, open the tap and release air until drops of water appear. The tip is then carefully inserted into the anus. Try to hold the liquid for at least 10 minutes. For best result You can do two enemas with a break of half an hour. It should be remembered that if the reason for visiting a proctologist is bleeding from the anus, then doing an enema is prohibited.

Two days before the appointment, the patient must follow a certain diet to eliminate excessive gas formation and the formation of a large volume of feces. To do this, exclude black bread, potatoes, legumes, raw vegetables and fruits, milk, carbonated drinks.

It is necessary to pay attention to special category patients who are at risk and need a scheduled visit to a proctologist. This group includes:

Preventive measures

Advice from proctologists will help prevent diseases of the rectum and large intestine.

By following these simple tips, you can stay in good physical shape for a long time and not need the services of a proctologist.

Proctologist - doctor narrow specialization treating various pathologies colon. Providing qualified medical care, he practices individual approach to every patient. Since diseases of this part gastrointestinal tract are not subject to general discussion, then one of the requirements for the proctologist is the maximum manifestation of delicacy. Often representatives of the stronger sex postpone visiting the doctor, which causes the progression of the pathology. A timely visit to a proctologist allows you to diagnose rectal disease at an early stage and immediately begin adequate therapy.

Before the examination, the proctologist explains to the patient the need for an endoscopic examination.

What does proctology study?

Proctology is a medical branch whose specialists study diseases of the large intestine and anorectal area. This allows you to quickly and effectively diagnose and treat pathologies, as well as prevent their development. To detect tumors or degenerative-destructive changes, proctologists use modern endoscopic techniques.

During the treatment process the following are used:

• pharmacological drugs;
• physiotherapeutic procedures.

If necessary, proctological surgeons perform minimally invasive surgical or abdominal manipulations. Such surgical interventions do not take much time and do not require a long rehabilitation period.

Warning: "In Lately The scope of activity of proctologists has expanded significantly. If previously they treated the rectum, now coloproctologists treat diseases of all parts of the large intestine, including the colon.”

A proctologist is a specialist who has extensive knowledge not only in the field of his profession. When diagnosing, a doctor is required to differentiate the symptoms of diseases of the large intestine from signs of urological, gynecological, venereological or oncological pathology. Therapy for many patients requires special psychological approach, because varieties and cancerous tumors are often found in people over 40 years of age.

The main problem with which patients come to a proctologist is symptoms of acute or chronic hemorrhoids

Types of medical specialization

In addition to the pathological processes developing in the colon, specialists in the field of proctology conduct research on them to develop preventive measures. Doctors treat congenital and acquired anomalies of various etiologies:

During the training process, a proctologist can choose a specific specialization that allows him to treat patients. There are two main types of professional activities:

If necessary, proctologists of different profiles can successfully replace each other. For example, a proctologist has the competence to stop dangerous bleeding, which occur when hemorrhoids rupture in people with diagnosed varicose veins of the large and small veins of the rectum.

What diseases does a proctologist treat?

A proctologist is a doctor who is able to quickly diagnose malignant or benign neoplasms in the rectum and offer effective therapeutic techniques. The main danger of colon cancer is its asymptomatic course at an early stage. Therefore, proctologists never tire of reminding patients of the need for annual preventive examinations. Doctors of this specialization treat the following diseases:

• acute and chronic constipation of various origins, diarrhea;
• disorders of the intestinal biocenosis of any etiology;
• acute and chronic colitis;
• incontinence caused by a decrease in the functional activity of the anal sphincter;
• rectal injuries after compression or impact;
• proctitis, cryptitis, paraproctitis;
• coccyx cysts;
• proctosigmoiditis;
• anal condylomas;
• congenital anomalies of the anorectal region in adults and children;
• rectal prolapse;
• pain in the colon of neurogenic origin.

Congenital pathologies

Anatomical lesions of the large intestine can be detected immediately after the birth of the child. These are exactly the pathologies that a proctologist treats surgical profile. The help of a physician of therapeutic specialization is necessary for incontinence of intestinal gases and feces in elderly patients. In women in the postpartum period, the cause of this pathological condition is a rupture of the perineum during the birth of a child. Proctologists treat postpartum sphincter insufficiency, which requires competent and timely medical intervention.

But most common problem The problem with which patients of all ages turn to proctologists is hemorrhoids and rectal fissures. When the pathology worsens, a person is unable to fully carry out the act of defecation due to severe pain. A characteristic feature of this delicate pathology is drops of blood on toilet paper after defecation. Symptoms of hemorrhoids also include:

• itching in the rectal area;
• swelling of the anorectal area.

Proctologists practice A complex approach for the treatment of hemorrhoids. Treatment of the disease is aimed at reducing the severity of symptoms, stopping the inflammatory process, eliminating the cause of pain and bleeding. After alleviating the patient’s condition, the doctor prescribes a course of medications to help restore the damage and prevent recurrence of hemorrhoids.

Warning: “Surgeries are performed only when conservative therapy fails, with preference given to minimally invasive techniques. As a rule, the help of proctologist-surgeons is resorted to if hemorrhoids are detected on last stage, characterized by loss of nodes.”

How to prepare for your appointment

Fecal masses are constantly formed in the human intestine, which will interfere with endoscopic examination. Therefore, you should prepare before the inspection. To fully cleanse the intestines, you can use several basic methods. The choice of technique is determined by the doctor, taking into account the patient’s age, general health, and history of diseases. How to prepare for an appointment with a proctologist:

• A few days before the examination, you need to exclude from your diet foods that can cause excessive gas formation. These include beans, lentils, peas, whole milk, White cabbage, radishes, potatoes;
• For 2-3 days daily you need to consume at least two liters of pure still water. It is better to replace strong coffee and tea with an infusion of chamomile flowers or rose hips.

Before use, wash the genitals and anorectal area under warm running water using hygiene products, and then wipe dry with a towel.

Use of laxatives

Proctologists most often recommend this method of quick cleansing to patients. Its undoubted advantage is the ability to carry out the procedure at home, without the involvement of a junior medical personnel. Previously, it was practiced to use laxatives that increase the tone of intestinal smooth muscle muscles:

• Senade;

Gradually, proctologists abandoned their use due to big list contraindications and side effects. Fortrans became the drug of first choice. The laxative quickly and effectively removes fecal matter from various stages formation, cleanses impurities in all parts of the intestines. Before taking the drug, you do not need to adhere to a diet or fast, and during the procedure the person does not experience any discomfort.

Using an Esmarch mug, a patient cleanses the intestines before being examined by a proctologist

The use of cleansing enemas

The optimal time for the procedure is late evening on the eve of examination by a proctologist or early morning. IN the latter case Please note that cleansing the intestines with an enema may take several hours. For the procedure, you will need an Esmarch mug with a volume of 2 or 3 liters, which can be purchased at any pharmacy. The device is filled with one and a half liters of water at room temperature and hung on a hook or simply held in a high-raised hand. Cleansing is carried out according to the following algorithm:

• the patient lies on his side and pulls his legs towards his stomach;
• the faucet opens and air is released from the device;
• greased vegetable oil or Vaseline, the tip is carefully inserted into the anus;
• Warm water is held in the rectum for 10-15 minutes.

For patients with large body weight, proctologists recommend performing bowel cleansing with an enema twice. This procedure is contraindicated for people suffering from intestinal bleeding of any etiology.

How does an appointment with a doctor work?

After the stage of preparation for examination by a proctologist, a primary diagnosis occurs. It begins with assessing the patient's condition and listening to his complaints. Then the proctologist conducts a series of examinations to help establish the suspected disease. The doctor examines the large intestine by palpation to assess the condition of its inner wall and possible detection of tumors. Endoscopic examination will be required to confirm the primary diagnosis. They allow you to visualize destructive changes in the rectum on a computer monitor, as well as outline a plan for the upcoming treatment. The most effective endoscopic procedures include:

• . Using a special anoscope device, the proctologist examines the inner surface of the colon. Before the procedure, patients may be administered drugs with analgesic activity;

All age groups are susceptible to hemorrhoids. It still remains one of the most common human diseases.

More than 15% of the adult population suffers from this disease. In the structure of proctological diseases it makes up more than 40%. Moreover, about half of all patients come to the doctor with III - IV stages of the disease.

Hemorrhoids can be acute and chronic course. And many predisposing factors lead to it.

about the project

Our medical portal I have collected useful and sufficient information for you detailed information about this unpleasant and insidious disease. Sections of the site will tell you about the causes of hemorrhoids and its symptoms.

By visiting our website, you will learn about the possibilities of medicine regarding the diagnosis and treatment of this disease. We provide you with information about a variety of methods. traditional treatment, familiarization with the possibilities of alternative treatment, as well as treatment with folk remedies.

Our site is the source useful tips. He will tell you about your options for preventing hemorrhoids and will help to involve people in preventive actions.

We are confident that the information offered will fill your life with comfortable well-being.

A proctologist carries out diagnostics, various types of treatment, and develops measures to prevent colon pathology. The patient consults a proctologist on the recommendation of a therapist or gastroenterologist. It is these specialists who will explain what a coloproctologist treats and give a referral to him.

A proctologist is a specialist doctor. The specialist diagnoses and prescribes treatment for pathologies of the colon, rectum, and anal area.

The name of the specialty of proctologist (proktos from Greek - rectum) has been considered obsolete in Russia since 1997. It has been clarified, special normative document(by decree) a decision was made to rename the profession. Now the doctor is called a coloproctologist (colon - large intestine, the term includes all its parts - rectum and colon). In fact, nothing has changed or become significantly different: before, this specialist treated all diseases of the rectum and colon.

A proctologist (coloproctologist) prescribes how conservative therapy, and is treated surgically. His main specialization in medicine is surgery. The field in which such a doctor works is called coloproctology. The name most often mentioned is proctology. It involves only surgical treatment.

How is a doctor's examination carried out?

During the initial visit, a survey is conducted (complaints and medical history are clarified), then the doctor examines the patient. An external examination and digital examination are carried out in the outpatient clinic. These methods are a kind of screening. They are informative and allow you to decide on methods further diagnostics. If the doctor is confident in the diagnosis after the diagnosis, a course of treatment is prescribed.

The proctological examination takes place on the couch in the knee-elbow position or on the back with the legs pressed to the stomach. Severe patients When examined, the patient is placed on the left side with the knees pulled towards the chest.

How to prepare for an examination?

Since to clarify the diagnosis, the proctologist finds out not only complaints and medical history, but also examines the patient, you need to prepare for the visit. At an outpatient appointment, a digital examination is performed, which requires clean bowel. Preparation is carried out 3-4 days before visiting the doctor and includes:

• dietary nutrition;
• enemas;
• laxatives.

Dietary food should be gentle. It is recommended to exclude:

• foods that promote increased gas formation (rye bread, raw vegetables and fruits, legumes, whole milk);
• carbonated sweet drinks, juices with pulp, whole milk;
• spicy seasonings;
• fatty, smoked dishes;
• sausages, canned food.

There are no restrictions on drinking other than those listed above.

In the evening before the examination and on the day of the examination, you need to perform 2 cleansing enemas (in the evening and in the morning, 3 hours before the diagnosis). If there is no constipation, it is enough to do one enema. It is better to use an Esmarch mug; its volume (about 2 liters) can be administered once. A pear-shaped enema is not very convenient for an adult.

If cleansing procedures using an enema are unacceptable for any reason, the doctor prescribes laxatives. Their choice depends on the condition of the intestines and the duration of constipation. This could be a pharmacy microenema Microlax, easy to use and fast-acting. The doctor may prescribe Fortrans - the drug is diluted with water and drunk. Available in dosed packages in powder form, the amount is calculated taking into account the patient’s weight. This medicinal substance It is preferable to use for severe constipation.

You can take a laxative as rectal suppositories or tablets.

At increased gas formation, if, despite the diet, it does not stop, an enterosorbent is prescribed - any drug from this group in an adequate dosage ( Activated carbon- 4-6 tablets once, Polysorb, Enterosorb). Espumisan is an effective antifoam agent that will also reduce flatulence.

If the proctologist plans to perform endoscopic examination using a special device (rectoscope, irrigoscope), preparation must be especially thorough, since the depth of examination is greater compared to digital examination:

• with sigmoidoscopy - 25 cm (the rectum and sigmoid colon are visualized);
• During colonoscopy, the entire large intestine is examined up to the bauhinian valve, which separates the colon from the small intestine.

If the patient is highly unstable or fears the procedure, it is recommended to take a sedative.

What laboratory tests does the proctologist prescribe?

From laboratory tests mandatory are:

• general clinical blood test;
• stool occult blood test;
• coprogram.

The blood test controls the formula - with hidden blood loss, anemia can develop.

The coprogram provides a number of indicators by which the existing disease can be differentiated. It can be used to check for the presence of pathology in others. digestive organs, detect intestinal inflammation, helminthiasis, fungi. When conducting research:

• the appearance, smell, and consistency of stool are assessed;
• pathological impurities are detected;
• microscopy, determination of proteins, fats, carbohydrates is carried out;
• undigested muscle and connective tissue fibers are determined;
• The presence of helminths and yeast is checked.

All results are presented in the form of a description of the detected pathology.

A stool occult blood test is prescribed for pain, constipation and other manifestations in which blood is visually absent. The advantage is the ability to diagnose hidden bleeding. The analysis is very sensitive - this is a kind of disadvantage. When determined, even a small level of not only human hemoglobin is detected, but also foreign hemoglobin obtained from food eaten (meat, fish). Therefore, lengthy preparation is required:

• a week before the test you need to stop taking iron, bismuth, acetylsalicylic acid and its derivatives, and other NSAIDs;
• for 3 days, exclude meat, fish, vegetables and fruits from the diet, switch to dairy products, rice, bread;
• You can’t brush your teeth 2 days in advance due to high probability microtrauma from a toothbrush.

If these restrictions are not met, the result of the study will be false positive and uninformative. It will have to be repeated.

List of pathologies that fall within the competence of a proctologist

The list of pathologies that a proctologist treats is very long. It includes diseases not only of the colon, but also of the anal area. Some of them:

• prolonged constipation;
• hemorrhoidal disease;
• prolapse of the intestine or enlarged venous nodes;
• any violation of the integrity of the mucous membrane (cracks, fistulas, erosions, ulcers);
• neoplasms;
• congenital pathology (dolichosigma, megacolon);
• inflammation of various etiologies (colitis);
• functional disorders(IBS - irritable bowel syndrome);
• diverticula, condylomas;
• intestinal obstruction;
• helminthiasis.

Hemorrhoids and anal fissure

Hemorrhoids are a common pathology of the rectum. This varicose veins veins of the rectum with the formation of nodes. With constant exposure to risk factors, congestion occurs in the pelvic vessels. The venous caverns around the rectum are filled with blood. Due to the impaired outflow of it from venous network there is a sharp protrusion individual areas hemorrhoidal plexus into the intestinal lumen with the formation of cones. Over time, their size increases, and the rectal ligaments that support the venous plexuses weaken. The nodes begin to fall out during physical effort (straining during bowel movements or lifting weights).

This refers to internal hemorrhoidal bumps that appear earlier and progressively grow in size. External nodes are located subcutaneously around the anus from the outside, so they cannot fall out.

The patient can notice the appearance of hemorrhoidal disease in the early stages. But he does not always pay attention to the symptoms that relate to it:

• stool disorders;
• itching or burning;
• sensation of a foreign object;
• traces of blood.

Such manifestations of the disease are often ignored. They rarely consult a doctor at this stage. When pain appears, bleeding due to damage to internal nodes, prolapse with strangulation, the patient comes to see a doctor. Pathology is often detected in advanced stage when complications develop:

• prolapse of nodes with strangulation and necrosis, sometimes with sepsis;
• proctitis, paraproctitis;
• bleeding;
• formation of a blood clot inside the node.

These are acute conditions. The patient needs assistance emergency care in a surgical hospital setting.

If not acute blood loss, but the release of blood in minimal quantities is disturbing; over time, severe anemia develops. Losses appear in the form of traces of blood:

• on linen and toilet paper;
• in feces after defecation.

Gradually appear:

• weakness, unmotivated fatigue;
• shortness of breath and palpitations;
• disturbance of appetite and sleep.

At early treatment Seeing a doctor can completely cure it. After the examination, the doctor will prescribe additional diagnostic methods and draw up a treatment plan. In the first stages, conservative treatment is carried out. It can be combined with traditional methods. If you follow all the specialist’s recommendations, you can easily get rid of the pathological changes that occur at the onset of the disease. In case of protracted course, when complications have formed, surgical methods are used. Dropping nodes are removed. The method of treatment depends on the stage of hemorrhoids.

An anal fissure is a defect of the mucous membrane. It has a linear or ellipsoidal shape (ulcer). It is formed when the mucous membrane is injured by hard feces, if the patient suffers from constipation. May be accompanied by pain, traces of blood in the stool or on underwear.

The development of a fissure is caused by a spasm of the sphincter when the blood supply to the tissues of the anus is disrupted.

When a crack appears, it is treated conservatively: prescribed generic drugs and topical ointments or creams.

Polyps and fistulas

Polyps is the term used to describe any growths in the wall of the intestine. According to their histological structure they are divided into the following types:

• true;
• false.

True - tumor formations (benign and malignant). These include:

• hemangioma;
• lipoma;
• adenoma;
• carcinoma;
• leiomyoma.

False polyps are formations inflammatory in nature or anal papillae that have reached large sizes. They are benign.

Considering that any polyp, even a small one (0.1 cm), can become malignant, it must be removed. This is done when conducting instrumental research methods, immediately after identifying a formation. After polypectomy, treatment is prescribed with the same instrument: local and conservative.

Diffuse (familial) intestinal polyposis occurs - a disease accompanied by the presence huge amount polyps - from several hundred to thousands. It is of hereditary nature. It almost always becomes malignant.

A fistula is a canal between two nearby organs. Rectovaginal fistula is common and is located between the rectum and vagina, since these organs are adjacent to each other in a woman. There are several reasons for the appearance of a fistula:

• purulent inflammation in one of the organs, when under the influence pathological process organ walls are destroyed;
• wall injury after surgical treatment on these organs.

The fistula is complicated by infection as a result of the penetration of feces from the rectum into the vagina.

Treatment of pathology is only surgical:

• dissection of the fistula canal;
• separation of organ walls;
• thorough removal of all pathological tissues;
• suturing defects.

Constipation and rectal prolapse

Constipation is a disruption in the normal passage of stool and its removal from the intestines. Accompanied by flatulence, pain, a feeling of incomplete emptying of the intestines, and a feeling of fullness.

The causes of this pathological condition are also:

• poor nutrition;
• sedentary lifestyle;
• stress;
• injuries and tumors of the intestines and spinal cord;
• pathology of other organs digestive tract;
• pregnancy.

Constipation is one of the main risk factors for the development of hemorrhoids and diverticula. Leads to increased blood pressure.

At chronic constipation Self-medication is strictly prohibited. You need to visit a doctor to find out the causes and prescribe adequate therapy. If necessary, the specialist will conduct an examination and explain what needs to be changed in lifestyle and diet. After a while, he will examine you again and monitor the results of the prescribed treatment.

To treat constipation the following are prescribed:

• diet;
• lifestyle changes;
• laxatives;
• surgery for intestinal obstruction - if formed fecal stone, or the intestinal lumen is sharply narrowed due to the tumor.

Constipation can be a manifestation of rectal prolapse: it protrudes beyond the anus. The pathology is not life-threatening, but brings a lot of inconvenience due to clinical manifestations:

• fecal incontinence;
• cosmetic defect.

The exact causes of the disease have not been established, but its appearance is facilitated by:

• congenital pathology of the development of the small pelvis and intestines;
• increased intra-abdominal pressure(occurs in late pregnancy);
• weakness of the perineal muscles and rectal ligaments.

These are the main, most common risk factors.

Most often this defect has to be removed surgically. There are many techniques for securing the rectum to surrounding tissues. If such a solution is not possible, resection of the protruding rectal part of the intestine is performed.

Injury and presence of foreign bodies

Abdominal trauma can cause the colon to rupture anywhere. As a result, feces will begin to flow into abdominal cavity with the development of peritonitis, which manifests itself clinically acute abdomen (intense pain, nausea, vomiting, hyperthermia). Inflammation of the peritoneum in such cases develops quickly, since the stool contains many bacteria, digestive enzymes. Without immediate assistance, death may occur.

A foreign body in the intestine obstructs the passage of feces, leading to perforation of its wall and the rapid development of peritonitis.

A foreign object enters the intestines:

• through the mouth - most often this occurs in children;
• through the anus - when measuring rectal temperature;
• from the outside - in case of injuries as a result of an accident, falls, wounds.

Other circumstances are possible.

To remove a foreign body, it is necessary to find out its nature:

• if it is a non-sharp object of insignificant size (a button swallowed by a child), apply therapeutic methods(laxatives, enemas);
• If the size or signs of perforation of the intestinal wall are sufficiently large, an operation is performed in the pediatric coloproctology department to save the patient’s life.

Anal itching and other diseases

Anal itching is unpleasant feeling in the anus, constantly or periodically occurring after bowel movement. In hemorrhoidal disease, itching is a sign internal hemorrhoids. The mucus that covers the prolapsed internal nodes and traces of feces on them irritate the skin. This unpleasant sensation also occurs with large external hemorrhoids, when after defecation with insufficient hygiene measures fecal residues are retained in the crypts and on the surfaces of the cones themselves, which leads to irritation and inflammation of the skin.

In addition to hemorrhoids, anal itching can be caused by:

• helminths;
• fungi;
• anal fissure;
• diarrhea;
• inflammation in the anorectal area;
• insufficient toilet.

If itching appears, you should not delay visiting a doctor in the hope that everything will go away on its own. In such cases, you need to consult a doctor as soon as possible so that after finding out the cause, you can get rid of the unpleasant symptoms forever. The specialist finds out the causes of itching and as soon as possible eliminates it.

A complication of hemorrhoids can be paraproctitis - inflammation of the perirectal fatty tissue. This occurs due to infection. The result of this pathology may be the development of:

• infiltrate - non-purulent inflammation;
• phlegmon - accumulation of purulent masses without clear boundaries;
• fistula - external or internal.

A common pathology of the large intestine is the identification of diverticula - protrusions of the intestinal wall into its lumen. Single hernial formations and multiple hernial formations may be detected - diverticulosis. It develops in patients if at least one pathological change the intestinal wall in the form of its protrusion. Diverticula can be of origin:

• congenital;
• acquired.

There are 2 types of diverticulosis:

1. Eastern type - protrusions are predominantly localized in the cecum and ascending colon; residents of the Far East suffer most.
2. Western - formations are located in the descending and sigmoid colon. This type is ten times more common. Distributed in Russia, Europe, USA.

Irritable bowel syndrome is a common pathology. These are functional disorders in intestinal activity in the absence of organic lesions in its walls. The reasons are:

• stress;
• junk food;
• taking certain medications;
• dysbiosis.

In addition, the term IBS refers to all intestinal dysfunctions when their cause has not been identified, and no gross pathology was found during examination.

Dolichocolon is a congenital anomaly of the large intestine: its length is too large. It can be extended along its entire length or only in one of the sections. Proceeds with unpleasant symptoms, up to the development serious condition. Worries about constipation due to chronic retention and accumulation of feces in the intestinal lumen, its significant expansion; with a long course, intestinal obstruction develops, anemia due to constant microtrauma of the walls, which can become pronounced over time. But for many decades, dolichosigma can be asymptomatic.

Megacolon also refers to a congenital intestinal pathology - this is a congenital expansion of the colon cavity. But it can form due to scars or other causes of narrowing (tumor, foreign body). If the causes are not established, megacolon is designated as idiopathic.

What is the difference between a proctologist and a coloproctologist?

Proctology consists of several disciplines - therapy, gastroenterology, endoscopy, surgery. This also includes oncology when detecting tumors in the intestines. Therefore, proctologist, or coloproctologist, which is the name of one specialty (outdated and new: since 1997, the specialty has been more common name- coloproctology), has knowledge about the structure, methods of diagnosis and treatment of pathology of the colon, anus and the surrounding area. The difference exists only in the name: most often in colloquial speech The name proctologist is still used.

How to get an appointment with a specialist for free?

To get an appointment with a proctologist for free, you need a referral from a therapist or gastroenterologist. You can independently obtain a coupon at the clinic reception and appear at the specified time for a consultation. But in a state hospital, such a highly specialized specialist as a coloproctologist may not be available. Therefore, you need to contact your local physician. He will also explain how to prepare for the examination, how to properly pass necessary tests, which can be done in advance and shown to the proctologist at the appointment.

In private clinics, any examination is carried out for a fee. Here you can take advantage of the compulsory medical insurance quota and, if necessary, get a consultation with a professor.

Can a surgeon replace a proctologist?

A coloproctologist is a specialist in a narrow profile, as opposed to a surgeon. general practice. But in the absence of a doctor of this specialization, if acute condition associated with intestinal pathology, an abdominal surgeon can provide assistance. It is especially necessary for the following:

• acute inflammatory processes (appendicitis);
• hemorrhoids (if bleeding appears, internal nodes fall out, or become pinched);
• proctitis or paraproctitis.

If there is no bleeding or prolapse of nodes, but it bothers you strong pain in the intestines, you can immediately contact a surgeon. It is important to do this as early as possible to avoid serious consequences.

What is the competence of a Proctologist?

What diseases does a proctologist deal with?

What organs does the proctologist deal with?

When should you contact a Proctologist?

When and what tests should be done

What are the main types of diagnostics usually carried out by a Proctologist?

If you sit a lot due to the nature of your work, then once an hour you need to take a 5-10 minute break for walking or other physical activity. It is better to replace an easy chair with a hard one.

Professional drivers should not drive for more than three hours at a time. Along the way, you need to take breaks, during which you should actively move.

You need to regularly strengthen your abdominal muscles to improve blood circulation in the pelvis.

The following set of exercises is possible (developed by specialists):
- Standing cross-legged, rhythmically tense the muscles of the buttocks and anus.
- Sitting on a chair with a hard seat, back straight, body slightly leaned forward, rhythmically tense the muscles of the anus.
- Lying on your back with your knees bent and your feet resting on your feet, which are shoulder-width apart, resting on your feet and shoulder girdle, lift off the floor and lift your pelvis.
- Lying on your back, alternately raise your straight legs.
- Lying on your back with your legs raised straight, spread your legs apart, then bring them together and cross them like scissors.
- Lying on your back with your legs elevated, move your legs as if you were riding a bicycle.
- Lying on your back, legs bent at the knees, press tightly to your stomach.
- From a lying position face down with emphasis on your knees, palms and elbows, rotate your pelvis alternately in both directions so that your buttocks touch the floor.

These exercises train gluteal muscles, anal sphincter and muscles abdominals, improve local blood circulation and blood outflow from the pelvic organs, stimulate the intestines, and promote the release of gases.

Exercises should be performed 10-15 times 2-3 times a day.

On the other hand, muscle strain in this area is contraindicated. Therefore, you should not do strength exercises. Cycling and horse riding will not be beneficial.

In your diet, stick to a diet that will not cause intestinal upset or constipation. This means that you need to eat less flour and dairy (except fermented milk), add bran to your food, and eat more vegetables.

Bifido-containing kefirs, etc. are required daily. Drinking mineral waters increases intestinal motility. Highly and moderately mineralized waters are recommended, as well as waters containing magnesium ions and sulfates, such as “Essentuki” No. 17 and 4, “Moskovskaya” - 1 glass at room temperature 3 times a day.

Wash yourself with cool water after each bowel movement. Considering that with a normally functioning intestine, daily bowel movements should be in the morning, this is quite realistic. By the way, they say that residents of rural areas in Central Asia do not have hemorrhoids, since they have been accustomed to such a hygienic procedure since childhood.

Don't overuse laxatives.

Preventive measures to prevent the appearance of hemorrhoids and their exacerbation:

Timely treatment of constipation and diarrhea (diarrhea), normalization of the digestive tract, regular and proper nutrition.

Remember - regulation of the consistency of intestinal contents and its transit through the colon is an indispensable condition not only for the prevention, but also for the successful treatment of hemorrhoids;

Limiting or avoiding the consumption of alcoholic beverages, highly spicy and salty foods;

Instilling hygiene skills from childhood. Thorough toileting of the anal area after each bowel movement. If necessary, refuse to use toilet paper and switching to washing with cool water and soap after defecation; in order to prevent exacerbations of the disease, cool manganese baths (pale pink solution) for 1.5-2 minutes after each bowel movement would be useful.

Persons with initial signs hemorrhoids, it is necessary to replace heavy physical labor with easier types of work;

In order to reduce venous stagnation in the pelvic organs, pregnant women are recommended daily exercises, walking, a rational diet with big amount laxative products, a ban on wearing tight belts;

Leading persons sedentary image life, should do gymnastics, swimming, and walk more.

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