I remember a patient, let’s call him John, sitting across from me, a worried frown creasing his forehead. “Doc,” he said, “you mentioned I might need to see a… a colorectal surgeon? That sounds pretty serious. What does that even mean?”
I completely understood his concern. It’s a title that can sound a bit daunting, can’t it? So, let’s chat about who these specialists are and why seeing one can be a really positive step for your health. If you’ve been told you need to see a colorectal surgeon, it’s natural to have questions.
So, What Exactly is a Colorectal Surgeon?
Think of a colorectal surgeon as a highly skilled doctor who specializes in looking after your large intestine. That’s your colon, rectum, and anus. These are vital parts of your digestive system, and sometimes they need expert attention.
You might have heard the term “proctologist” in the past. “Colorectal surgeon” is simply the more current term for essentially the same specialty. Why the change? Well, “proctologist” technically just refers to the rectum and anus. “Colorectal” more accurately covers the colon and the rectum, which make up the biggest part of your large intestine. But don’t worry, a surgeon by either name is trained to care for all these areas.
When Might You Need to See a Colorectal Surgeon?
Usually, your journey doesn’t start with a colorectal surgeon. You’d typically see your family doctor (like me!) or perhaps a gastroenterologist – that’s a specialist in digestive diseases – if you’re having issues with your lower gastrointestinal (GI) tract.
Now, if we, your primary doctors, think your condition might need surgery, or a very specialized type of investigation, that’s when we’ll suggest a visit to a colorectal surgeon. It’s all about getting you the most focused care.
Some common reasons we might make this referral include:
- Concerns about colorectal cancer or a strong family history of it.
- The presence of polyps (small growths) in your colon or rectum that need expert removal or closer watching.
- Inflammatory bowel disease (IBD), like Crohn’s disease or ulcerative colitis, especially if it’s complex or not responding well to other treatments.
- Problems with blood flow to the intestines, which we call ischemia.
- Structural issues, such as:
- Anal fistulas (little tunnels forming where they shouldn’t).
- Hernias involving the bowel.
- Rectal prolapse (where part of the rectum slips down).
- Pelvic organ prolapse in some cases.
And here’s something interesting: while their main playground is the large intestine, colorectal surgeons are also fully trained general surgeons. Our bodies are so interconnected, right? So, they often end up treating other nearby organs that might be involved, like parts of the small intestine, the pelvic floor muscles, the urinary system, or even the female reproductive system if a condition affects those areas too.
What Makes Them the Experts?
Becoming a colorectal surgeon is quite a commitment. In the U.S., for instance, they first complete at least five years of training as a general surgeon. Then, they do an additional year of specialized residency focusing just on colorectal conditions. After all that training, they need to pass rigorous exams to become certified by the American Board of Colorectal Surgery.
What they really dive deep into during their extra training is the complex workings – the physiology – of your intestines and anorectal region. This in-depth knowledge makes them uniquely qualified to diagnose and treat intricate problems with the precision and care they demand.
What Can a Colorectal Surgeon Do for You?
Alright, so if you do go see a colorectal surgeon, what kind of things do they actually do? They have a whole toolkit of techniques and procedures.
Diagnostic and Treatment Techniques:
These doctors are skilled in a range of approaches, from less invasive to more complex surgeries:
- Endoscopy: This involves using a thin, flexible tube with a camera on the end.
- Colonoscopy: You’ve probably heard of this one. It allows a thorough look inside your entire large intestine and can often be used to remove polyps right then and there.
- Enteroscopy: Similar to a colonoscopy, but designed to examine the small intestine.
- Sigmoidoscopy: This looks at the lower part of your colon (the sigmoid colon), rectum, and anus.
- Laparoscopic Surgery: Often called “keyhole surgery.” The surgeon operates through a few small incisions using special instruments and a camera. This usually means a quicker recovery for you.
- Robotic Surgery: This is an advanced form of laparoscopic surgery where the surgeon controls robotic arms. It can offer even greater precision for very delicate operations.
Common Procedures They Perform:
Depending on what’s going on, a colorectal surgeon might perform procedures like:
- Polypectomy: Removing those polyps we talked about, often during a colonoscopy.
- Endoscopic Mucosal Resection (EMR) / Endoscopic Submucosal Dissection (ESD): These are advanced endoscopic techniques to remove tricky tumors or growths without traditional surgery.
- Bowel Resection Surgery: This means removing a diseased part of your large or small intestine.
- Ostomy Surgery: Sometimes, it’s necessary to create an opening (a stoma) on the abdomen for waste to pass out of the body. This could be a colostomy (from the colon) or an ileostomy (from the small intestine). They also perform surgeries to reverse ostomies when possible (anastomosis surgery).
- Appendectomy: Removing an inflamed appendix.
- Anoplasty: Surgical repair or reconstruction of the anus.
- Rectopexy: Repairing a rectal prolapse.
- Hernia Repair: Fixing intestinal hernias, often using laparoscopic or robotic methods.
Important Diagnostic Tests:
To get a clear picture of your health, they also conduct various tests:
- Digital Rectal Exam: A fundamental, quick physical examination.
- Anoscopy / Proctoscopy: Using a short, lighted scope to examine the anus and rectum.
- Defecography: A special X-ray that looks at how your rectum functions during a bowel movement.
- Endorectal Ultrasound: An ultrasound probe is used to get detailed images of the rectal wall and surrounding tissues.
- Anorectal Manometry: This test measures the pressures of the anal sphincter muscles to check their function.
Conditions a Colorectal Surgeon Treats
It’s a broad list, but these specialists are equipped to handle many different issues affecting the lower digestive tract. You might see a colorectal surgeon for:
- Colorectal Cancers:
- Colon cancer
- Rectal cancer
- Anal cancer
- And other less common types like appendix cancer or neuroendocrine tumors.
- Colorectal Polyps and Inherited Polyposis Syndromes:
- Conditions like Familial Adenomatous Polyposis (FAP) or Lynch syndrome.
- Complicated Inflammatory Conditions (Colitis):
- Severe diverticulitis (inflammation of pouches in the colon)
- Ulcerative colitis
- Crohn’s disease
- Appendicitis
- Ischemic colitis (due to poor blood flow)
- Functional Bowel Disorders:
- Pelvic floor dysfunction
- Fecal incontinence (difficulty controlling bowels)
- Obstructed defecation (difficulty passing stool)
- Structural Defects:
- Large bowel obstructions
- Anal fistula or rectovaginal fistula
- Rectal prolapse or pelvic organ prolapse
- Perianal abscess (a collection of pus near the anus)
- Benign (Non-Cancerous) Conditions:
- Hemorrhoids (piles)
- Anal fissures (small tears in the anal lining)
- Persistent rectal bleeding
- Severe or complicated constipation and fecal impaction.
Take-Home Message: What to Remember About Colorectal Surgeons
It can feel like a lot of information, I know! But here are the key things I hope you’ll take away:
- A colorectal surgeon is a highly trained medical expert specializing in your colon, rectum, and anus.
- You’ll typically be referred to one if your family doctor or gastroenterologist thinks surgery or a specialized procedure might be the best way to manage your condition.
- They use a variety of advanced techniques, from endoscopies like colonoscopy to minimally invasive surgeries.
- These surgeons treat a wide spectrum of conditions, from common issues like hemorrhoids to serious diseases like colorectal cancer and IBD.
- Don’t ever hesitate to ask questions. They, and we, are here to help you understand your health and your treatment options.
So, if your path leads you to a colorectal surgeon, please know you’re being guided to someone with very specific skills to help with that part of your body. We’ll always talk through why a referral is being made and what you can expect. You’re not alone in this, and you’re certainly in capable hands.