Proctology is the branch of medicine dealing with diseases of the rectum and anus, which are the final section (part) of the digestive tract (path).
The most common diseases treated by a proctologist are:
- hemorrhoidal disease
- polyps of the anus
- anal fistulas
- anal inflammation, anal abscess
- hair cysts
- condyloma acuminate
- anal pruritus (itching)
In our Clinic we deal with the diagnosis and treatment of diseases within the range of proctology.
An important part of diagnosing proctology problems is the interview and a per rectum examination.
Diagnostics, anoscopy or rectoscopy performed using the highest class video-rectoscope produced by BOB Optical Fibre Technique, we are the only Clinic in the Tri-City that has this equipment.
We use the Proctology Research Card recommended and used by the team of doctors from the Proctology Department of the Hospital in Solec.
In practice patients with symptoms of hemorrhoid disease come to a doctor dealing with proctology. A hemorrhoid disease (is the presence of troublesome bleeding nodules, often erroneously described as varices of the anus-see the explanation below).
This applies in particular to patients with sedentary lifestyle, with chronic constipation, pregnant women and after childbirth.
Treatment of hemorrhoid disease is possible non-operatively at the Phlebology Clinic.
- sclerotherapy method (Dr. Pejganowicz, as one of the few out of 50ty doctors in Poland, has appropriate certificates of being trained in the treatment by this method)
- Barron’s method (that means, the rubber garter method).
- by radio-wave thermoablation.
In the course of diagnostics, if necessary, samples are taken for histopathology examination- thanks to this it is possible to assess the nature of the changes.
Hemorrhoid disease.
Bleeding nodules or hemorrhoids are a normal anatomical structure. They perform a function in the mechanism of holding gas and stool (keeping the tightness of anus) and defecation. As a result of many reasons (among others, constipation, a low-carb diet, diarrhea, obesity, pregnancy, hereditary tendencies) these nodules can become pathologically enlarged.
Hemorrhoid disease is a condition in which bleeding occurs from the enlarged bleeding nodules, their prolapse and sometimes thrombotic changes.
Hemorrhagic disease occurs in several stages.
- Stage I – enlarged bleeding nodules are present only in the anal canal, do not fall out (prolapse) through the anus.
- Stage II – nodules falling (prolapsing) out during defecation while pushing on the stool withdrawing spontaneously after defecation with bleeding and discomfort, but without pain.
- Stage III – prolapsing ( falling out) hemorrhoids requiring manual discharge with bleeding and/or mucous discharge, sometimes painful.
- Stage IV – hemorrhoids are outside all the time and cannot be drained inside the anus, they are accompanied by bleeding, pain, possibility of thrombosis (clots).
Depending on what stage it is at the appropriate type of treatment is chosen:
- Preventive treatment – a high-residual diet with plenty of liquids and application of pharmacological products, weight reduction in case of obesity.
- Treatment with the use of non-surgical methods.
- Surgical treatment (surgical excision).
Symptoms of the disease are:
- an annoying itching or burning in the anal area
- leaving traces of stool or bright red blood on stool, underwear, or toilet paper.
- a feeling of incomplete defection.
It must be remembered that the itching, bleeding from the anal area are not always cause by hemorrhoids, but may be an indication of other diseases , so it is worthwhile to seek advice and make the right diagnosis.
ATTENTION.
The earlier the treatment, preventing further development of the disease, the greater the possibility of avoiding surgical treatment.
AN EXPLANATION.
Anal (rectal) veins can develop in the course of cirrhosis and portal hypertension . in these patients there is decompression of the portal hypertension into the upper rectal vein ( which normally drains blood to the portal system) through the middle and lower anal vein. And veins unlike esophageal veins, are not affected by portal hypertension.
Anal veins unlike esophageal veins bleed rarely.
In patients with portal hypertension the occurrence hemorrhoid disease is not frequent.
Proctologic examination.
The examination requires patience, tact, as the ailments concern the intimate sphere, which is often accompanied by embarrassment and fear. Therefore, we make every effort to make the patient feel safe and comfortable.
A proper proctologic examination consist of:
- Examination of anus and perineum.
- A palpation examination.
- Examination per rectum ,in women often per vagina.
Examinations: anoscopy or rectoscopy, using the latest equipment from the company BOB Optical Fibre Technology.
Preparation for anoscopy and rectoscopy on the day of the examination, a cleansing infusion (hegar) in the morning 2hours before the examination using ready-made preparations- enema or rectanal- available at pharmacies.
The patient has to prepare himself at home.
Anoscopy.
An examination involving the insertion of a short speculum (anoscope) into the anus to assess the perianal area.
Preparation for anoscopy:
On the day of the examination, a cleansing infusion ( hegar) in the morning 2hours before the examination, using ready-made preparations-enema or rectanal-available at pharmacies.
The patient has to prepare himself at home.
Rectoscopy.
An examination involving the insertion of a long speculum (rectoscope) into the rectum in order to assess the rectal area and additionally the final section of the large intestine.
Preparation for rectoscopy:
On the day of the examination, a cleansing infusion ( hegar) in the morning 2hours before the examination, using ready-made preparations-enema or rectanal-available at pharmacies.
The patient has to prepare himself at home.
Sclerotherapy of hemorrhoids.
It is a non-surgical treatment of hemorrhoids based on the injection of an obliterating agent into the affected area with the aim of reputing the nodule and thus eliminating the pain. Sometimes the treatment has to be repeated.
During the treatment an anoscope is inserted so the patient practically does not feel the insertion, therefore, it can be said that it is painless, short, and minimally invasive. After the treatment the patient can leave the Clinic immediately.
Barron rubber bands.
Treatment of hemorrhoids with the Barron method is a technique minimally invasive, non-surgical and safe when treating rectal varices.
It is based on placing rubber bands around the neck of the bloody nodules, which leads to their fibrosis and separation within a few days.
The procedure does not require hospitalization and is basically painless, after the treatment the patient can return to his daily activities.
Barron’s method is the most commonly used as a minimally invasive technique of treating hemorrhoids.