A coloproctologist or simply a proctologist - since 1997 the official name of a doctor’s specialty in European medical standards - is engaged in the treatment and diagnosis of pathologies of the large intestine. It includes the cecum, colon, sigma and rectum. Invasive procedures are performed by a proctologist surgeon.
What does the proctologist treat?
A proctologist deals with colon diseases. It:
- inflammation
- polyps;
- ulcerative colitis;
- intestinal obstruction;
- hemorrhoids;
- injuries of the colon, foreign bodies falling into its ducts;
- tumors;
- prolapse of the rectum;
- proctitis and paraproctitis;
- anal fissures and abrasions;
- diverticulum-like protrusion of the rectal wall in the direction of the vagina in women (rectocele).
When do I need a proctologist consultation
This must be done with the following symptoms:
- Stool instability - the tendency or alternation of diarrhea and constipation; with chronic constipation, the walls of the intestine are stretched, which leads to the appearance of diverticula, anal fissures or hemorrhoids.
- Blood on toilet paper, linen or in feces - is considered an alarming symptom, can occur with exacerbation of hemorrhoids, fistulas, polyps and cancer.
- Hemorrhoidal nodes - prolapse, inflammation, thrombosis and enlargement of nodes is accompanied by pain, itching, a feeling of having a foreign body in the anus that prevents sitting, lying down. In 79% of cases, hemorrhoids result in colorectal cancer.
- Pain during bowel movements - occurs with sphincter spasms and anal fissures, with tumors. If untreated, the process becomes purulent.
- Tenesmus (false desires) can also be considered dangerous - they are painful for the patient, as they cause pain and a feeling of incomplete emptying after straining.
Also, a proctologist needs to be visited by everyone after 50 years for a routine examination. You can contact him yourself or in the direction of the therapist. He also needs to learn how to prepare for the examination of the proctologist at the initial appointment.
Preparation for the visit
Why is she important? To get a reliable inspection result. Preparation takes almost a day.
How to prepare for a proctologist? The first visit to the proctologist is not associated with a special bowel cleansing, because the examination is not a colonoscopy. It is enough to have dinner with a panicle salad and a glass of kefir for the night, so that there is a chair in the morning.
Then you can go to the reception. How to prepare in other cases? If there is no intestinal bleeding and sharp pains, the intestines should be cleansed by enema or laxatives.
How to prepare for a woman visiting a proctologist? Basically, the preparation does not differ from that in men, but she must necessarily conduct thorough and proper hygiene of the perineum with appropriate cosmetics.
Preparatory procedures
How to prepare for proctologist enemas? 2 enemas are prescribed - the night before and in the morning, between them a gap of 6 hours, no less. Also often practice 2 enemas in the evening and 1 in the morning.
2 enemas in the evening should be carried out with an interval of 45 minutes to an hour so that the washings after the first enema come out completely.
How to prepare for a proctologist in terms of nutrition? Not recommended foods that enhance fermentation in the intestines: milk, cabbage, fresh vegetables, brown bread, muffin. If your stomach is still full of gas, take Espumisan or a couple of tablets of activated carbon.
Esmarch's Mug for Enema
It is a metal or rubber tank up to 2 liters. The bottom of the cup has an opening from which a rubber tube with a tip at the end departs.
This plastic tip is easy to clean and sterilized in des. solution. Its length is not less than 8 cm, it is with smooth edges and smooth.
There is a tap on the tube to adjust the water pressure. The water for the enema is only boiled, slightly warm, with a temperature of 28-36 degrees. With a colder intestine, it can cramp, and a warmer fluid is simply absorbed without leaving the intestine.
After a set of water, the mug is fixed at a height of 1.5 m to create a pressure. Water is released from the tip to release it from the air, the tip is lubricated with petroleum jelly and carefully introduced into the anus by rotational movements.
Procedure
The patient lies on an oilcloth, on his left side, with his legs down. The body is as relaxed as possible. The tip is first advanced 4 cm straight, then slightly directed down. Open the valve and drain the water. If you feel an obstacle, the tip is pulled back, the valve is opened. Then the stool softens.
A person immediately has a feeling of fullness of the intestine, but water cannot be released immediately. It is better to lie on your back after administration for about 10 minutes, breathing deeply, but not often. For abdominal pain, stroke the stomach in a clockwise direction. Then the intestines can be emptied.
Esmarch's mug rinses the intestines better than a pear enema, because its volume is larger. It’s more convenient for someone else to do the enema.
Method number 2 - according to Hegar: the technique is the same, but the knee-elbow position. You can do an enema yourself in this position on all fours in the bathroom. At one time, you can enter no more than 1.5-2 liters of water.
Reception at the proctologist
The doctor examines visually, by palpation and instrumental. How to prepare for a proctologist for an initial appointment? In addition to cleansing the intestines, you need to prepare answers to possible questions and do not forget to describe all your complaints. Most often this is pain, itching, mucus in the rectum, a feeling of an empty bowel, etc. Descriptions should be detailed for clarity. With blood discharge, the amount, color of blood should be described.
Then the doctor clarifies the points he needs for diagnosis:
- stool frequency;
- the feeling of incomplete bowel movement;
- a change in overall well-being in the form of weakness or headaches;
- nutrition features;
- self-administered or other treatment;
- the presence of concomitant pathologies, especially from the gastrointestinal tract.
Next is the inspection itself. The patient in the examination room strips below the waist and puts on disposable underpants with a slot in the anus. Inspection takes place when the patient is on the side or in an upright position in the elbow-elbow position on the couch.
The anus is visually inspected and palpated. The condition of the anus, sphincter, rectal mucosa, the presence of hemorrhoids, polyps in the rectum are assessed.
Anoscopy
If necessary, anoscopy is performed. Anoscope is a narrow funnel with a slot on top and a handle. The depth of introduction to the rectum is 12-13 cm. The procedure is safe, but unpleasant. Shame should not be. After an anoscope, the doctor almost always prescribes a sigmoidoscopy or colonoscopy. And although in many articles they claim that sigmoidoscopy is supposedly almost a pleasure, it is better to conduct it with anesthesia. No doubt, the method is informative and necessary, but painful.
Contraindications to the examination
There are a number of contraindications for any type of study of the anal area and rectum.
- Severe pain - if the pain, even with palpation, is pronounced, the patient is given an analgesic, examination is carried out later.
- Narrowing the rectum, spasm of the sphincter muscles - examination is not only painful, but also dangerous.
- Exacerbation of the disease - acute paraproctitis, bleeding hemorrhoids, thrombosis of hemorrhoids. First, anti-inflammatory treatment is required. And then inspection.
- Vasodilation due to varicose veins, profuse bleeding, severe respiratory failure - no instruments are introduced into the intestine. Bleeding requires treatment to a complete stop.
The problem of patients is that without an instrumental examination by a proctologist, a diagnosis is impossible. On examination, pain cannot be tolerated, immediately inform the doctor about your feelings, then it is easier for a specialist to navigate in the pathology zone.
Diet
It is also necessary to observe certain nutritional rules. This is the second moment of preparation. How to prepare for a trip to a proctologist? How to eat? The diet must be observed within 2 days before the visit. It is not recommended to use products that give gas formation: milk, brown bread, cabbage, legumes, some vegetables and fruits, soda. Food on the eve of the day is only light - broth, boiled eggs, tea, biscuits.
It is best to starve if possible. The intestines will then be easier and better cleaned, the procedures will be carried out with the greatest result. How to prepare for a proctologist and can I have breakfast? If the visit is scheduled for the morning, then it is better not to have breakfast.
If the visit is in the afternoon, a light breakfast is possible.
How to prepare for a proctologist using other methods? Another option is to drink 2 tbsp. A day before visiting a doctor. l castor oil or 2-3 capsules. Oil can be replaced with Epsom salt.
Simultaneously, exclude:
- greens;
- all vegetables;
- berries - they contain fiber.
On the day of admission, it is better to drink more, you can drink a glass of sweet tea.
How to prepare for the examination of a woman?
How to prepare for a visit to a proctologist woman? Different women need different training. A non-pregnant woman of childbearing age should visit a proctologist after completing the menstrual cycle.
How to prepare for a proctologist examination for a woman during pregnancy or during lactation? During gestation, cleansing is carried out with a pear enema or Microlax. They are used 2-3 hours before a doctor's appointment. Their use is very convenient, but in terms of efficiency is much weaker than traditional enemas.
How to prepare for a proctologist for a woman with constipation? Then 2 ordinary enemas are made in the evening and 1 enema in the morning.
Microclyster Cleansing
"Microlax" can be used for children up to a year. The tube contains a special thick white oil solution for gentle bowel cleansing, the packaging capacity is 5 ml. The intestinal microflora is not disturbed with it, the action begins in 10-15 minutes. 1 syringe - 1 time.
How to prepare for the proctologist "Microlax"? Its use is very simple: after opening the capsule, it is carefully inserted into the anus, its contents are squeezed out.
To obtain the desired effect, you need to do several enemas before taking a proctologist. With intestinal inflammation, constipation or damaged mucosa, microclysters are contraindicated.
Laxatives
How to prepare for a visit to a proctologist without enemas? There are laxatives for this - the easiest way to clean. Their advantages - an enema is not required, does not give flatulence and does not need a diet, do not require outside help. Contraindications - intestinal obstruction.
Only the advice of a doctor is required, which remedy is best. The most popular are Fortrans, Endofalk and Dufalac.
Among other laxatives:
- 30% magnesia or Epsom salt: per glass of water - 60 ml of the product. Relaxation will begin in an hour and continue throughout the day.
- Castor oil - calculation of 1 g / kg weight. It is added to a glass of water at room temperature.
- Capsules of glycerin or petroleum jelly - also have a laxative effect by softening feces.
- Further, you can note “Lavacol”, “Pirilax”, “Bisacodyl”, “Dulcolax”, “Guttalax” and much more - the choice is quite wide.
The drug "Fortrans" based on polyethylene glycol is specially designed to prepare patients for a proctologist, you can use it even with open wounds in the anus.
How to prepare for a visit to the Fortrans proctologist? The right amount is calculated by weight: 1 sachet per 20 kg of weight, it is diluted in 1 liter of boiled water. The taste is sweet and salty. Preparation begins the day before at 6 p.m. 1 liter of solution should be taken in a full glass every 15-20 minutes per hour.
The action of "Fortrans" most often begins after 3 hours and lasts up to 6 hours. Sometimes it can last until the morning. It cleanses well, but leaches microflora, so after a proctologist, replenish it with prebiotics. The tool, according to the instructions, is not recommended for frequent use. It is contraindicated in cases of ULC, obstruction of the intestines, unclear abdominal pain.
Dufalac
Hyperosmotic laxative, where lactulose is active. Release form - syrup with a pleasant taste. The drug additionally normalizes the intestinal microflora.
A single dose of administration is 45 ml per half a glass of water. If the visit is before noon, apply the instructions for the morning appointment. If in the afternoon, the instructions for the daily appointment are used.
If the appointment is scheduled for the morning?
The day before the visit in the morning you need to drink 200 ml of liquid: water, broth, juice, compote, tea or coffee. After that, take the drug, dissolving the contents of the bottle (45 ml) in 120 ml of water.
Instead of lunch, you also need to drink up to a liter of liquid. Dinner also consists of a glass of liquid. Another dose of the drug is taken. If you wish, you can drink again later.
If the appointment is for lunch?
The day before the visit, instead of lunch, you can broth. Instead of dinner, up to 500 ml of liquid. The tool is taken in the evening after dinner, also dissolving the contents of the bottle in half a glass of water, you can drink it. Before going to bed, you can drink another 3 glasses of liquid.
In the morning - a glass of liquid, and after - taking the drug in the same proportion - 1 bottle per half a glass of water. The chair will appear in the time interval from 30 minutes to 6 hours.
"Flit Phospho-Soda"
It has a very good composition in the form of lemon and ginger oil. The package contains 2 bottles of 45 ml. It is not so popular, but it is also often used. The scheme of its administration is as follows: in the morning the day before the visit to the proctologist they drink a glass of liquid - tea, water, coffee, compote, juice.
1 bottle of the drug is diluted in half a glass of water and washed down with another glass, just like Duphalac.
At lunchtime, the volume of water or liquid drunk is at least 3 glasses. In the evening, the second dose of "Flit" using the same technology + a full glass of water. Defecation occurs in the interval from half an hour to 6 hours. By the way, Fleet is not used to treat constipation.
Many are worried about the need for removable underwear. Modern clinics do not require any linen. Everything is thought out in them, and the staff must create the most comfortable conditions.
Is it possible to replace the examination by a proctologist with something? Most likely no. To make an accurate diagnosis, the doctor must conduct an instrumental study. Intestinal pathologies may not give themselves away, asymptomatic. Therefore, if the doctor recommends an examination, it is better to go through it. Perhaps this will save your life. The main thing is to remember that the reliability of the study largely depends on preparation for it.