Proctology
Proctology is the specialty that nobody likes to talk about, even though it affects almost everyone at some point.
Proctology treats diseases of the rectum and anus. These include, for example, hemorrhoids, fissures or fistulas. But functional disorders such as constipation, defecation disorders or faecal incontinence also belong in this exciting area. Defecation is a highly complex process that requires a healthy anal region. We usually only realize how important this region of the body is when it no longer functions properly. At Swiss1Surgery, we have many years of highly specialized experience with diseases and disorders in this intimate area and can treat you competently and sensitively.
Which proctologic diseases are common?
Haemorrhoids
Hemorrhoids are enlarged vascular cushions in the anal canal. The cushions are present in all people – we only speak of hemorrhoids when they are too large and cause symptoms. Hemorrhoids are very common and are promoted by hard bowel movements, a low-fiber diet and prolonged sitting. The disease often progresses in phases, i.e. the symptoms can wax and wane over time. With small hemorrhoids, good stool regulation is often enough to achieve a soft bowel movement. Ointments also help to alleviate the symptoms. From a certain size, however, surgery is often unavoidable for sustainable treatment.
Typical symptoms of hemorrhoids are blood in the stool, itching, foreign body sensation or leaking mucous membrane. A doctor should always be consulted if these symptoms occur.
Hemorrhoids are basically harmless, but they can be extremely annoying and lead to a significant reduction in quality of life.
Hemorrhoid operations are performed in an outpatient setting. We will be happy to advise you and work with you to find the right treatment.
Fissures
Fissures are small tears in the mucous membrane directly between the anus and the skin. They are often very painful and can also bleed easily. They can be healed with good stool regulation and ointments that relax the sphincter muscle. If a fissure does not heal within 6-8 weeks after this therapy, it should be excised in a minor operation.
Fistulas
Fistulas are connections from the rectum to the skin. They usually occur as a result of an abscess on the anal verge. They are very annoying and should definitely be treated, otherwise they can repeatedly lead to inflammation and thus damage to the sphincter muscle.
Anal skin tags
Anal skin tags are skin lobules on the anus that belong to the human body and do not normally cause any symptoms. However, they can restrict anal hygiene, make cleaning difficult or cause itching. They can then be removed in a minor operation.
Malfunctions
Defecation disorders are often caused by a mechanical obstruction, for example an internal or external rectal prolapse or bowel prolapse. In this case, the rectum protrudes into itself, which can lead to an obstruction of bowel movements. Such a prolapse can be treated with laparoscopic surgery. This involves stretching the rectum with the help of a plastic mesh and allowing the stool to be emptied.
In the case of incontinence, the sphincter muscle must first be examined. If there is sufficient muscle, biofeedback therapy (a type of physiotherapy) can often achieve a significant improvement in continence. Otherwise, treatment options include suturing the sphincter muscle or installing a neurostimulator (a type of pacemaker), which improves the function of the sphincter muscle.
What diagnostic options are available in proctology?
The most important thing is to talk to us. We can often suspect the diagnosis afterwards. We then carry out the clinical examination in the lateral position. We look at the anal region, feel for hardening or swelling with our finger and finally insert a proctoscope (a plastic tube with a light source) into the anus so that we can see the mucous membrane. This examination is not painful and only takes a few minutes.
Sometimes additional examinations with an ultrasound device or MRI imaging are required.
Where and how are proctologic operations performed?
Many proctological operations such as hemorrhoids, fissures or anal skin tags can be performed on an outpatient basis. We perform outpatient procedures in the gastroenterology group practice or at the Opera outpatient surgery center in Bern.
For more complex procedures, we operate in an inpatient setting at the Beau-Site Clinic in Bern.
What is important after proctologic surgery?
As the anal region is very sensitive, adequate pain therapy is required after a procedure. Sufficient recovery time is also required after minor procedures. It is also important that the stool is not too hard. We therefore always prescribe a laxative for the first few days. Open wounds on the anus are cleaned with water, special dressings or ointments are not necessary for healing.