Proctology

A proctology clinic examines and treats diseases of the anus, rectum, and the lower section of the large intestine. The most common complaints include hemorrhoids, anal pain, bleeding, inflammation, and bowel movement disorders. Early detection of serious conditions that may develop without symptoms is also a key objective.

Who is a proctologist?

A proctologist is usually a surgeon, and less commonly a gastroenterologist–internist with experience in the treatment of rectal diseases. Their responsibilities include performing instrumental examinations (anoscopy or rectoscopy), surgical treatment of hemorrhoids, and the management of anal fissures.

With what symptoms should I see a proctologist?

• Bloody stools or fresh blood on toilet paper
• Pain, burning sensation, or itching around the anus
• Pain or fissures associated with constipation
• Swelling, lump, or a feeling of prolapse in the anal area
• Persistent mucous discharge or oozing
• Changes in bowel habits after the age of 40
• Hemorrhoidal complaints during pregnancy or after childbirth
• Follow-up examination of a known proctological condition
• Preventive screening as part of colorectal cancer screening

What conditions does proctology treat?

• Hemorrhoidal disease (internal and external)
• Anal fissure
• Perianal inflammations, abscesses, fistulas
• Skin and soft tissue lesions around the anus
• Rectal polyps and tumorous lesions
• Inflammatory conditions associated with constipation
• Early detection and follow-up of rectal cancer
• Differential diagnosis of proctological complaints

Which proctological diseases are common at different ages?

At a younger age, mostly easily treatable inflammatory processes require proctological or surgical examination and treatment. After the age of 40, hemorrhoids become increasingly common in both women and men. Many people struggle with frequent constipation and the resulting inflammation, as well as anal fissures that cause severe pain and bleeding. In older age, the possibility of rectal cancer must also be considered.

How is a proctological examination performed?

• Discussion of symptoms
• Physical examination
• Instrumental diagnostics – rectal endoscopy (using modern techniques, painlessly, within a few minutes)

Hemorrhoidal Disease

Hemorrhoids are abnormal dilations of the venous plexuses around the anus, which may cause bleeding, pain, itching, or prolapse. In early stages, the condition can be effectively treated with medication and lifestyle changes. In advanced cases, it can also be successfully treated with outpatient, non-surgical procedures.

External hemorrhoids

• Clearly visible and palpable
• Often painful
• May be accompanied by inflammation and bleeding

Internal hemorrhoids

• Not visible, usually painless
• Fresh red bleeding draws attention to them
• In advanced stages, they may prolapse and become incarcerated

What treatment options are available?

• Medical treatment (suppositories, ointments, local preparations)
• Lifestyle and dietary counseling
• Rubber band ligation (Barron ligation) – painless, outpatient procedure
• Sclerotherapy
• Infrared coagulation or laser treatment
• Surgical solution when indicated

Some proctological surgeries are performed in the surgical department of a private hospital.

When is follow-up necessary?

• If symptoms do not improve within 1–2 weeks
• To assess the effectiveness of medical treatment
• After an outpatient procedure
• If bleeding or pain returns
• To discuss histological results
• As part of a screening protocol, even without symptoms

Related examinations and services

• One-day surgical care
• Surgical outpatient clinic
• Gastroenterological evaluation
• Colonoscopy
• Virtual colonoscopy
• Histological examinations

FAQ – Proctology

Is a proctological examination painful?

No. The examination is performed with modern instruments and usually involves only minimal discomfort.

Can I eat on the day of the examination? Is an enema or laxative necessary?

You should have a bowel movement a few hours before the examination. Enema or laxatives are not required.

What does a rectal examination mean?

It is a rectal examination performed as a screening procedure, not as an instrumental intervention. The doctor inspects the anus to assess external hemorrhoids or possible dermatological lesions. Wearing gloves and using lubricating cream, the doctor gently examines the inner surface of the rectum with a finger to check for internal hemorrhoids or rectal tumors.

After a proctological procedure, do I need bed rest or can I return to work the next day?

As an outpatient, bed rest is not necessary. However, prolonged sitting (such as office work) is not recommended on the day of the procedure and the following day.

Is bleeding always a sign of hemorrhoids?

No. Bleeding may also be caused by other, potentially more serious conditions, therefore medical evaluation is necessary.

When is screening recommended?

If there is a family history of colorectal cancer, screening is recommended annually from the age of 40. Otherwise, annual screening is advised from the age of 45.

Can surgery be avoided?

Yes, most proctological diseases can be treated in early stages with conservative or outpatient methods.

This article was prepared with the contribution of Dr. György Ledniczky.