Proctologist and proctological surgery in Niš

Proctological surgery is part of general surgery. It deals with conditions of the last part of the large bowel (the rectum), the anal canal and the surrounding skin, including the area above the tailbone. The most common conditions are haemorrhoids, anal fissure, anal abscess and fistula, and pilonidal sinus. Less common are hidradenitis around the anus and on the buttocks, and rectal prolapse. Many of these conditions are first treated without surgery: through changes to diet, regulating bowel movements and medicines recommended by the doctor. An abscess, by contrast, is usually treated with a minor surgical procedure. Whether a surgical procedure is recommended depends on the findings and the doctor's assessment. Larger operations on the colon and rectum, such as resections, are described on the General and abdominal surgery and Gastrointestinal surgery pages.

A consultation with a proctologist is most often booked when someone notices blood in their stool or on toilet paper, when there is pain, itching, swelling or discharge around the anus, or when their usual bowel habits change. A consultation is also booked on the recommendation of a GP. Blood in the stool does not always have the same cause, so the cause needs to be established by a doctor. Do not wait for a booked appointment if the bleeding is heavy or does not stop, if your stool is black, if you have a high temperature together with pain and swelling around the anus, or if the pain keeps getting worse. In that case, contact a doctor without delay or call an ambulance on 194. Many people put off this examination because they feel embarrassed. For the doctor it is a routine examination, and it is carried out with respect for your privacy.

The examination begins with a conversation about the patient's symptoms, diet, bowel movements and the medicines they take. The doctor then examines the skin around the anus, in a position the doctor chooses, for example while the patient lies on their side. This is followed by a finger examination (digital rectal examination): the doctor uses a gloved finger with gel to examine the last part of the bowel. If needed, the doctor also looks inside the anal canal using a short instrument with a light (anoscopy). The examination is usually short. It may be uncomfortable, but it is usually not painful. If the area is very painful, for example with a fissure, the doctor may adapt or postpone part of the examination. At the end, the doctor explains the findings and recommends further treatment or additional tests, for example a colonoscopy or imaging.

If an operation is needed, the surgeon explains what the procedure involves, what the treatment options are, what the possible risks are and what recovery to expect. The necessary tests are done before the procedure. If the procedure is done under spinal or general anaesthetic or under sedation, there is also an assessment by an anaesthetist beforehand. The type of anaesthetic depends on the procedure (local, spinal, general or sedation) and is decided by the surgeon and the anaesthetist. Whether the patient goes home the same day or stays in hospital is decided by the surgeon, based on the type of procedure and the patient's general health. After the operation the patient receives instructions on wound care, diet and bowel movements, as well as a follow-up appointment. Returning to work and physical activity is agreed with the surgeon.