Proctology is a medical specialty that focuses on the diagnosis and treatment of diseases of the rectum, anus and colon. These conditions can be uncomfortable or even debilitating, but many of them have effective solutions when detected early. Below, we will explore the most common diseases in this field, their causes, symptoms and available treatment options.
What is Proctology?
Proctology deals with the final structures of the digestive tract, including the rectum and anus. This area is particularly prone to disorders due to the continuous transit of faeces and the interaction with factors such as diet, bowel habits and systemic conditions of the body.
Common Pathologies in Proctology
- Haemorrhoids:
- These are swollen veins in the rectum or anus that can be internal or external.
- CausesChronic constipation, straining during bowel movements, pregnancy or sedentary lifestyle.
- SymptomsRectal bleeding, painful bowel movements, itching and sensation of a lump in the anus.
- Anal Fissure:
- A tear in the lining of the anal canal, often caused by difficult bowel movements.
- SymptomsSevere pain during and after bowel movements, slight bleeding and muscle spasms.
- Anorectal Abscesses and Fistulas:
- Infections in the anal glands that may form pus-filled cavities (abscesses) or tunnels between the anus and the skin (fistulas).
- CausesBacterial infections or inflammatory diseases such as Crohn's disease.
- SymptomsPain, fever, swelling and pus discharge.
- Rectal prolapse:
- It occurs when part of the rectum protrudes through the anus.
- CausesPelvic floor muscle weakness, chronic strain or ageing.
- SymptomsVisible protrusion, faecal incontinence or difficulty in passing stools.
- Faecal Incontinence:
- Involuntary loss of control over bowel movements.
- CausesSphincter muscle damage, nerve injury or previous surgery.
- Inflammatory Bowel Diseases (IBD):
- Diseases such as ulcerative colitis and Crohn's disease can affect the rectum and anus, causing chronic inflammation.
- SymptomsDiarrhoea with blood, abdominal pain and anal fissures or abscesses.
- Colorectal Cancer:
- A malignant tumour affecting the colon or rectum.
- Risk factorsAge, family history, low-fibre diet and inflammatory bowel diseases.
- SymptomsChanges in bowel habits, rectal bleeding, weight loss and fatigue.
Diagnosis in Proctology
The diagnosis of these pathologies is made by means of:
- Physical Exploration:
- It includes a visual and tactile examination of the anal and rectal region.
- It includes a visual and tactile examination of the anal and rectal region.
- Imaging tests:
- Anoscopy, sigmoidoscopy or colonoscopy to assess the condition of the anal canal and rectum.
- Anoscopy, sigmoidoscopy or colonoscopy to assess the condition of the anal canal and rectum.
- Functional Tests:
- Anorectal manometry studies to assess muscle function.
- Anorectal manometry studies to assess muscle function.
- Biopsies:
- To rule out diseases such as colorectal cancer or specific infections.
Common Proctology Treatments
Treatment varies according to the pathology and its severity:
- Lifestyle changes:
- Fibre-rich diet to prevent constipation.
- Adequate hydration and regular exercise.
- Medical Treatments:
- Creams and suppositories to relieve the symptoms of haemorrhoids and anal fissures.
- Antibiotics in cases of abscesses or infections.
- Outpatient Procedures:
- Elastic band ligation for haemorrhoids.
- Drainage of anorectal abscesses.
- Surgery:
- Haemorrhoidectomy: In severe cases of haemorrhoids.
- Fistulotomy: To treat anal fistulas.
- Rectal prolapse: repair by laparoscopic techniques.
- Tumour Resection: For colorectal cancer.
- Advanced Treatments:
- Biological therapy for inflammatory bowel diseases.
- Sacral neuromodulation for faecal incontinence.
Prevention of Proctological Pathologies
- Maintain healthy bowel habits, avoiding prolonged straining during bowel movements.
- Regular check-ups, especially if there is a family history of colorectal disease.
- Avoid a sedentary lifestyle and eat a balanced diet rich in fibre.