Reception at the proctologist. How is it for women, men, how to prepare for menstruation, pregnancy, hemorrhoids

It is worth making an appointment with a proctologist when problems appear in the anal canal or rectum. Additionally, the doctor assesses the condition of the vaginal tract and testicles (in women and men, respectively). Reception is painless. Thanks to the examination, it becomes possible to timely identify possible pathologies and prescribe treatment.

Who is a proctologist, what tests can he prescribe

A proctologist is a narrow-profile doctor who can diagnose and treat diseases of the large and small intestines, anus. Most often, it is the proctologist who helps patients get rid of such an unpleasant pathology as hemorrhoids.

What is the difference between a proctologist and a coloproctologist?

They are one and the same specialization. Originally, proctologists were called so because of the Greek word proktos, which means rectum. However, in 1997 g. this form has been deprecated. They decided to rename the profession, since the proctologist does not exclusively diagnose and treat the rectum.

Therefore, they decided to add the prefix colo to the name of the profession, since the Greek word “colon” ​​is translated as “large intestine”, which more reflects the real activity of a specialist. The fact is that the large intestine includes many departments, including the rectum and colon.

Since patients are used to calling the doctor a proctologist, this form is used to this day. Moreover, quite often, even in the clinics themselves, this particular name of the specialty can be seen on the plate in the doctor's office. However, it is more correct to call a specialist a coloproctologist.

What pathologies does the doctor treat?

Proctology covers a huge list of a wide variety of diseases.

Most often, patients who suffer from:

• lingering constipation;
• hemorrhoidal diseases;
• rectal prolapse (prolapse of the rectum), as well as in the case of an increase in venous nodes;
• cracks, fistulas, or ulcers in the mucous membrane;
• neoplasms (can be benign or malignant);
• pathologies of a congenital nature (for example, dolichosigma);
• colitis and other types of inflammation;
• functional disorders (eg, irritable bowel syndrome);
• diverticulum or genital warts;
• obstruction of feces;
• helminthiasis.

When is a visit to a proctologist required?

Reception with a proctologist is not in the most pleasant way, but this is a necessary measure if a person suffers from:

• the appearance of cracks in the anal area;
• enlarged varicose veins;
• purulent lesions on tissues located in the anal area;
• mechanical trauma to the intestines and the anus.

Alarming symptoms, even if they are of a short-term nature, may indicate rather serious intestinal pathologies. Most of these diseases are very sluggish, hidden. The fully clinical picture begins to unfold only when the problem can be stopped exclusively by surgery.

It is imperative to visit a proctologist when:

• Prolonged constipation or, conversely, frequent diarrhea. Such symptoms may indicate a disease of one or another organ of the gastrointestinal tract. Also, frequent flatulence is observed with neoplasms. Symptoms are typical for intestinal obstruction. Constipation is a particularly dangerous condition, as when the stool hardens, it begins to damage the delicate lining of the intestines. As a result, numerous cracks and bleeding appear. They, in turn, provoke the formation of hemorrhoids. In addition, constipation can aggravate the pathology already proceeding in a sluggish form, provoking its progress.
• Bloody discharge in the feces. If at least a few drops of blood remain on toilet paper or underwear, then you should immediately contact a proctologist. Allocations of a similar nature do not disappear on their own. By themselves, bleeding is a sign of cracks, fistulas, polyps, and even a malignant tumor.
• The appearance of hemorrhoids. With such a pathology, a person experiences a number of characteristic symptoms. For example, after a bowel movement, a rather strong burning sensation appears, as well as a feeling of discomfort in the anus. It seems to a person that his intestines have not been emptied enough. Also, after a bowel movement, there may be a feeling of the presence of a foreign body in the anus. When these symptoms appear, it is very dangerous to self-medicate. Such manifestations are characteristic not only of the external type of hemorrhoidal disease. A similar symptomatology is observed with the formation of internal hemorrhoids. Without proper treatment, they can fall out or be pinched. This can provoke a more dangerous condition - sepsis or acute thrombosis.
• Severe pain during bowel movements, as well as in the case of the so-called false urge to defecate.

With a timely visit to a specialist, you can avoid consequences hazardous to health.

Preparation for inspection

An appointment with a proctologist takes place in several stages. First of all, you need to prepare for a visit to a specialist. The preparatory stage includes cleaning the intestines from residual decay products and getting rid of possible gas formation.

Thanks to these stages, the patient will save himself from awkward situations during the appointment with the doctor. It is necessary to take into account the physiological manifestations of the digestive system. For example, during an appointment with a doctor, an involuntary bowel movement may occur. If there is nothing in it, then an embarrassing situation can be avoided.

In addition, bowel cleansing is required in order for the doctor to conduct the highest quality examination. In the process of examining the rectum, specialized equipment (for example, an anoscope) is used. If there are decay products in the rectum, then the view, even with the help of special devices, will be difficult.

It is possible and even necessary to refuse preparatory measures for those who suffer from very severe pain in the anus. In all other situations, it is worth adhering to a few simple rules.

Enema or laxative

Before the initial examination by a specialist, you can do without cleansing the intestines. Usually, at the first appointment, the doctor conducts only a visual examination and prescribes the examination procedure for the next day. However, if the patient complains of chronic constipation, then rectal cleaning is performed anyway on the eve of an appointment with a proctologist.

If the appointment is scheduled earlier in the morning, then an enema or laxative is recommended to be used before bedtime. If a doctor's visit is scheduled for the evening, then bowel cleansing procedures are recommended in the morning of the same day.

When using an enema, you can choose one of 2 methods: use an Esmarch mug or a special micro enema. In the first case, water and a special device for setting enemas are used to cleanse the intestines.

When using Esmarch's mug, the algorithm of actions will look like this:

1. First, you need to fill Esmarch's mug with warm water in a volume of 1.5-2 liters.
2. After that, the tip of the product must be greased with a fat cream, ointment or petroleum jelly.
3. At the next stage, the patient lies down on a horizontal surface on the left side and pulls the knees to the stomach. It is required to lay a towel under the buttocks area.
4. Next, the assistant fixes the Esmarch mug itself in his hands so that it is at a height of about 1.5 m.
5. At the next stage, it is necessary to carefully insert the tip of the product into the patient's anus and open the valve of the device so that clean water begins to flow into the rectum.
6. The patient should take a horizontal position until he feels as if he is starting to burst.
7. After that, he must quickly go to the restroom and have a bowel movement.

Esmarch's mug allows you to carry out the most effective bowel cleansing. It is a safe and inexpensive method to prepare for an appointment with a specialist. However, the cleaning process itself causes many negative emotions in patients. In addition, the procedure can be painful and requires the presence of another person.

This method is not used when:

• acute pain syndrome in the anus;
• inflammation in the anal canal;
• bleeding in the intestines;
• the presence of anal fissures.

In this case, you can use the so-called micro enema. This is a more gentle procedure that you can do yourself. At the same time, the patient experiences significantly less discomfort. Most often, a drug called Mirolax is used as a micro enema.

The procedure for using such an enema is as follows:

• First of all, you need to wash your hands well, as well as the anus.
• After that, you need to carefully remove the micro enema from the package and break off the tip of the tube. This should be done immediately before using the drug.
• After that, you need to carefully start pressing on the tube so that a few drops of the composition come out of it. They will serve as a lubricant.
• The next step is to carefully insert the tip into the anus and squeeze out the entire contents of the enema. If the procedure is performed on a child under 3 years old, then you need to use only half of the product.
• It remains only to remove the tube and wait 5-15 minutes until the patient has the urge to defecate. After a bowel movement, it is usually necessary to repeat the procedure several times. However, it all depends on the individual characteristics of the patient.

Appointment with a proctologist does not necessarily require prior use of enemas. If the visit to the doctor takes place in the morning, then in the evening of the previous day, you can use a laxative. But it is not recommended to prepare like this for an evening reception for several reasons. First of all, it is very difficult to independently calculate the dosage of the drug and determine exactly when it will begin to act.

The body can react completely unpredictably to a laxative. For example, a patient may develop diarrhea. Also, such funds have a rather high load on the cardiovascular system and are not recommended for those who suffer from pathologies of the digestive system.

If there are no contraindications, then you can use one of several means:

A drug	Release form	Dosage (single dose)
Duphalac	Syrup	45 ml
Portalak	Syrup	30-45 ml
Lactulose	Syrup or suspension	30-45 ml
Good luck	Syrup or tablets	15-30 ml or 1 tab.

Diet

If the patient first visits a specialist, then, as a rule, there is no need to adhere to a strict diet. It is enough not to eat spicy and fried foods a day before the appointment.

You also need to exclude marinades, canned food, sweets and alcohol. In order to avoid getting into an awkward situation (gas on palpation) when examined by a doctor, it is important to exclude products that have a laxative effect. This can provoke not only flatulence, but also an inaccurate diagnosis.

Foods that can provoke flatulence include legumes, nuts, and carbonated drinks. Also, the day before the appointment, you should exclude beer, cabbage in any form, kefir and pastries from your diet.

Other recommendations

Appointment with a proctologist is very nerve-racking for some patients. To overcome anxiety and stress, you can take a drug with a mild sedative effect. It is best to give preference to products of natural origin. For example, you can take valerian tablets.

The desired effect can be achieved by taking the drug Tenoten. You should start taking it about a week before your doctor's appointment.

Preparatory activities should include standard hygiene procedures. Immediately before taking, you should wash the anal area and genitals. At the same time, it is not advisable to use hygiene products that have an antiseptic effect.

Such funds negatively affect the condition of the skin, which can also lead to an incorrect diagnosis.

Who is the procedure contraindicated for?

If we are talking about contraindications to visual inspection, then they do not exist.

However, palpation or examination using instruments is undesirable when:

• severe bleeding;
• very severe pain syndrome;
• loss of a node;
• narrowing of the posterior canal;
• thrombosis;
• respiratory failure.

As a rule, the examination is postponed until the patient begins to experience relief.

Features of visual inspection

Visual inspection is one of the main stages of diagnosis. To do this, the patient takes a knee-elbow position, and a special tissue with a hole is applied to his buttocks. If the patient is experiencing severe pain or difficulty in posture, the proctologist may ask him to lie on his left side and pull his knees up to his chest.

Most of the rooms are equipped with closed examination rooms, so the patient feels more comfortable. There are also some differences in the conduct of the examination among representatives of different genders.

Passage of the procedure for a woman

If the patient of the proctologist is a woman, then most often she is offered to be accommodated for examination in a chair that is very reminiscent of a gynecological one. While the doctor makes the examination, the patient is on her back (legs are set on fixing supports), the pelvis should be slightly raised.

If there is no specialized chair, then the doctor may ask the woman to take a knee-elbow position. If the patient is pregnant and the gestation period is more than 20 weeks, she lies on her side on the couch.

Usually in medical institutions there are proctologists of two sexes, so in order not to feel embarrassed, you can always make an appointment with a doctor for a man or a woman.

Examination of men

An appointment with a proctologist takes place in this case, not only in order to identify any problems in the rectum, but also in order to assess the condition of the prostatic gland. In this regard, male patients are offered to take a knee-elbow position.

Procedure steps

The survey includes several stages:

1. First of all, the doctor interviews the patient. He specifies what exactly he is complaining about, whether there is pain, from which pathologies the man or woman additionally suffers. After collecting the anamnesis, the proctologist gets a general idea of ​​the possible pathology.
2. At the 2nd stage, a visual inspection is carried out. The doctor asks the patient to take a position on a couch or chair, after which he examines the shape of the anus and the condition of the skin around it. At this stage, he can identify the so-called gaping of the sphincter, scars, fistulas and possible deformities. Also, the specialist assesses the condition of the hemorrhoids (if any). At this stage, the doctor in most cases can determine the stage of development of the disease. Visual inspection lasts no more than 5-6 minutes. It is completely painless.
3. Stage 3 consists in palpation (digital examination). The doctor applies a lubricating gel to his fingers and the patient's anus, after which he feels the hemorrhoids that may be inside the rectum. At this stage, he can also detect the presence of ulcers, tumors and cracks. This part of the examination can be uncomfortable.
4. At the 4th stage, an examination is carried out with the help of instruments.

Instrumental diagnostics can be performed using several methods:

• Anoscopy. Before such an examination, a digital examination is mandatory, since the doctor must make sure that there are no formations in the patient's rectum that can be accidentally touched by the anoscope. This instrument is a rectal mirror with an additional small LED. The anoscope is able to penetrate 14 cm deep, which sometimes becomes enough to make a correct diagnosis.
• Sigmoidoscopy. In this case, an endoscope is used, which is equipped with a miniature camera. Thanks to this device, the proctologist can examine the condition of the rectum at a depth of 60 cm. The data obtained are highly accurate, since the doctor receives a visual image of the mucous membrane. The resulting images are digitized and studied in detail by a specialist. Thanks to this procedure, it is possible to clarify the presence or absence of oncology.
• Colonoscopy. This endoscopic method is considered one of the most accurate in the examination of the intestine. A colonoscope is used to conduct it. It is a lightweight, bendable probe that can penetrate all parts of the large intestine and part of the small intestine. The probe does no damage. Colonoscopy is in many ways similar to sigmoidoscopy, but unlike it, it allows you to study many more areas. The medical probe is capable of penetrating to a depth of 152 cm. This makes it possible to reliably determine if there are problems in the distant parts of the intestine. Also, when performing a colonoscopy, the doctor can remove small polyps (up to 1 mm). Immediately after this procedure, the doctor can examine the tissues and determine if they are precancerous. If during the examination the doctor removes polyps or cauterizes them, then this can be a rather painful process. Therefore, in such situations, colonoscopy is performed under general anesthesia.

In addition, the patient may be prescribed an irrigoscopy. This is an X-ray study that is only used for contour diagnostics. Irrigoscopy does not allow obtaining accurate information about the relief of the colon, therefore, this procedure is prescribed only as an additional examination.

Examination of pregnant women

If we are talking about a pregnant woman, then usually only an external examination is carried out. Other diagnostic measures are prescribed only in case of urgent need. For example, if a diagnosis of thrombosed external hemorrhoids is made, the patient experiences unbearable pain. In this situation, a thrombectomy (removal of a blood clot) may be required.

However, most often, doctors resort to medication and prescribe drugs that are allowed to be taken during pregnancy, as well as during lactation. However, without consulting a doctor, in no case should you start taking them yourself. Also, in some situations, the doctor transfers the instrumental examination to the postpartum period.

Each situation is individual and depends on many factors. For example, if the woman's condition is satisfactory, and the gestation period is still very small, then anoscopy is allowed.

X-ray examination is not recommended, as well as more serious measures. In addition, pregnant women should not carry out preparatory measures before an appointment with a coloproctologist. Taking a laxative or using an enema can cause uterine contractions.

Visit your doctor during your period

The doctor has no right to refuse a patient an examination if she is menstruating. However, it is worthwhile to carry out preparatory measures and pay special attention to hygiene procedures. It is recommended to use tampons before visiting a doctor.. These intimate hygiene products will not interfere with the examination in any way.

However, with menstruation, it is very difficult to make a correct diagnosis. Therefore, the proctologist is usually limited to visual examination and taking anamnesis. He can also do digital examination and anoscopy, but most likely the procedure will have to be repeated after the end of your period.

During the period of menstruation, the doctor does not prescribe therapeutic therapy. Therefore, if the situation is not urgent and there is an opportunity to wait for the completion of menstruation, then it is better to visit a doctor after that.

Seeing a proctologist scares a lot of people. However, there is absolutely no reason to worry. Even the most detailed examinations are usually painless, and if necessary, the patient is put into a state of sleep. The procedures themselves are carried out quickly in a separate closed room.

While a proctologist's appointment scares many people, there is absolutely no reason to worry. Even the most detailed examinations are usually painless, and if necessary, the patient is put into a state of sleep. The procedures themselves are carried out quickly in a separate closed room.

Video about an appointment with a proctologist

Question-answer about the examination by a proctologist: