Proctology is the medical area dedicated to diseases of the rectum and anus . It is an area that is shared by two medical specialties, general surgery and gastroenterology . In many cases, both a general surgeon and a gastroenterologist can manage these diseases. However, there are specific treatments for gastroenterology and there are specific treatments for general surgery. When medical care should be sought For diseases of the rectum and anus, the main symptoms that should lead patients to consult a physician, are: Pain; Exit of blood through the anus; Local swelling; Modification of intestinal habits. These symptoms can be signs of several diseases, such as common benign diseases like hemorrhoids , and anal fissures or fistulas . Hemorrhoids Hemorrhoids are the most common disease in the proctology area. They may have no symptoms, but in up to 50% of cases there may be complaints that interfere with quality of life. People with symptoms should seek medical attention, as most cases are successfully resolved. Hemorrhoids are dilations of blood vessels, protruding from the anal canal. They can be: External, when they are located around the anus; Internal, which, depending on their severity, may or may not be visible. The most frequent complaints related to hemorrhoids are: Loss of live blood through the anus, usually after evacuation; Presence of swelling; Pain, which usually presents as a discomfort. Hemorrhoids treatment generally begins with the adoption of healthy lifestyle habits, with physical exercise and diet modifications increasing the amount of fluids and fibers. In appropriate cases, obesity is also combated in this way. It is also important to modify bowel habits , correcting constipation, either through food or, in some cases, using laxatives. To relieve symptoms, sitz baths and medications can also be used. In case there are no improvements, surgical options may be indicated. Perianal fistulas Perianal fistulas are small channels that are formed between the intestine and the skin. Many perianal fistulas are due to obstruction of drainage channels from glands in the anal canal wall that are next to the anal sphincters. This obstruction causes an inflammation and induces the formation of a fistulous channel . Usually, this channel goes towards the body surface and opens at the level of the skin draining the content. However, it is often necessary to intervene, make an incision, drainage and treatment with antibiotics. Anal fissures Anal fissures are often a single lesion and are located in the posterior midline of the anus. They Can be: Acute, when they appear suddenly; Chronic, when they have been present for some time or appear and disappear frequently. Anal fissures appear frequently in patients with constipation and are due to trauma caused by exertion during defecation and the emission of hard and bulky stools. Anal fissures often heal spontaneously . In other cases, medical treatment and sometimes surgical treatment are required. Proctology Surgery When surgery is necessary, there are several options in these diseases, from the most classic surgery, in which for hemorrhoids and perinanal fistulas, they are removed, to others procedures, less invasive, such as the treatment of hemorrhoids by ligation or coagulation or, most recently, by laser surgery. Laser surgery is done with almost no incision or tissue removal. This technology allows treating the surgery in a practically non-invasive way and, therefore, with less pain, especially in the postoperative period. Technological developments have been providing new solutions for the treatment of diseases of the rectum and anus, which no longer require prolonged recovery processes, with inactivity and an important impact on quality of life. Author : Vitor Costa Meet the General Surgery and Gastroenterology team of Hospital da Luz network and book your consultation The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
