What exactly is coloproctology?
The colorectal surgeon (or coloproctologist) is a physician, specialist in General and Digestive Surgery, expert in the diagnosis and treatment of problems of the large intestine or colon, rectum and anus.
The colorectal surgeon has the theoretical knowledge and specific skills to perform the diagnosis and treatment of benign and malignant diseases of the colon, rectum and anus, being sufficiently demonstrated, through the best scientific evidence available, that patients with coloproctological diseases have superior results when they are cared for and treated by colorectal surgeons.
In the United States and Canada, Coloproctology is a specific surgical subspecialty, which requires an official training program at the end of the specialty of General and Digestive Surgery. In many European countries, including Spain, it is advisable to organize a section or unit dedicated to Coloproctology in the reference hospitals for the care of patients with coloproctological diseases, although these units are still integrated in the General and Digestive Surgery services, although the need to officially regulate the training and specific dedication to this field is recognized.
In Europe, the European Union of Doctors and Specialists (UEMS) accepted Coloproctological Surgery as a surgical subspecialty in 1997. As a consequence, an accreditation and certification program in Coloproctology was developed, and since 1998 there has been a European Board of Surgery Qualification in Coloproctology (EBSQC) Diploma in Europe.
In Spain, the Spanish Association of Coloproctology (AECP) is the scientific society that brings together surgeons specifically dedicated to this field and whose primary purpose is to promote knowledge and training in Coloproctology. The AECP organizes and coordinates training programs in Coloproctology, develops standards of quality of care and results in this pathology, as well as registers and supervises the accreditation of the different Coloproctology Units, advocating for its official recognition as a subspecialty or specific training area in Surgery.
What differentiates a proctologist from a coloproctologist?
The proctologist further specializes in the pathology of the end of the rectum, anus and pelvic floor. The proctologic surgeon has a deeper knowledge of these pathologies, in diagnosis, in the use of specific diagnostic tools for the anal canal and pelvic floor, such as anuscopy, endoanal ultrasound and anal manometry.
In addition, the proctologist is part of different multidisciplinary groups to optimize the management of these patients, having close contact with other specialists who treat pelvic floor problems such as urologists, gynecologists, rehabilitators and physiotherapists of the pelvic floor and anesthesiologists specialized in the management of pelvic pain.
What diseases or pathologies does the proctologist treat?
Pathologies of the anus include:
- Anal fissure
- Abscesses and anal fistulas
- Hemorrhoids
- Anal itching
- Pilonidal sinus
- Hidradenitis
- Condylomas and other sexually transmitted infections affecting the anus.
- Pelvic floor pathologies, which are defecation dysfunctions due to constipation and obstructed bowel movements, anal incontinence and pelvic organ prolapse.
Which are the most common?
Anal pathology is very common, more than you might think. Patients usually consult for bleeding or discomfort always thinking they have hemorrhoids, but there is a wide variety of conditions that may present.
In addition, nowadays the taboo about incontinence is being eliminated, and many women, and also men, consult for gas and stool leaks.
This means that we have ample room for improvement for our patients.