Proctologist
We specialize in the diagnosis, treatment, and prevention of diseases of the anal region, anal canal, rectum, and colon. A proctologist is a general surgeon specializing in the treatment of diseases of the anus and rectum. These conditions include hemorrhoids, anal fissures, fistulas, and more. Treatment may be conservative (lifestyle and dietary changes, medications, creams) or surgical (ranging from simple minimally invasive procedures under local anesthesia to major operations under general anesthesia).
When Should You See a Proctologist?
Disorders of the anal and rectal area are common. Because these are sensitive issues, many people hesitate to seek medical attention. However, you should never postpone a visit to a proctologist out of embarrassment. Our doctors treat every patient with understanding and professionalism. Contact us as soon as the first symptoms appear so we can quickly find the most suitable solution together.
Consult a proctologist if you have:
- a positive fecal occult blood test (during colorectal cancer screening or a routine check-up);
- pain or discomfort in the anal or perineal area;
- blood on toilet paper or bloody discharge from the rectum;
- lumps, fissures, or ulcers around the anus;
- rectal prolapse;
- a sensation of incomplete bowel emptying or a foreign body in the rectum;
- mucus or pus discharge from the rectum;
- suspected hemorrhoids.
Who Is at Risk?
- People with a sedentary lifestyle and unhealthy diet
- Pregnant women and women after childbirth
- Overweight individuals
- People with sedentary or standing occupations — office workers, salespersons, drivers
- Patients with a hereditary predisposition whose close relatives have had colorectal cancer or intestinal polyps
- Women during menopause — hormonal changes increase the risk of proctological diseases
The most common proctological problems are hemorrhoids, anal fissures, and anal fistulas. Modern proctology also deals with obstructed defecation syndrome and identifying its causes, as well as diagnosing and treating rectal and colon tumors. An essential part of proctology includes modern diagnostic methods such as endoscopy (anoscopy, rectoscopy, colonoscopy), endorectal ultrasound, defecography, and magnetic resonance imaging (MRI).
Hemorrhoid Treatment
Hemorrhoids are varicose veins in the anal canal that cause unpleasant symptoms in both men and women. Although hemorrhoids are rarely dangerous, they can recur and become painful and bothersome. Hemorrhoids are caused by multiple factors, the most common being:
- genetic predisposition (e.g., hereditary constipation);
- constipation and straining;
- prolonged diarrhea;
- sedentary lifestyle;
- unhealthy diet;
- alcohol consumption;
- heavy physical work;
- pregnancy and childbirth.
There are two types of hemorrhoids: internal hemorrhoids, located in the lower rectum, and external hemorrhoids, which develop under the skin around the anus. Internal hemorrhoids initially cause few symptoms, with bright red bleeding being the most characteristic sign. Without proper treatment in the early stages, they may prolapse during bowel movements and become problematic. External hemorrhoids are usually more painful, and when thrombosis develops, the pain becomes severe and the hemorrhoid forms a hard lump. A bump or swelling may be visible or palpable around the anus.
It is important to note that blood or mucus in the stool may also indicate other diseases. Therefore, in addition to home remedies, it is strongly recommended to consult a doctor to rule out more serious conditions. A proctologist will diagnose the condition and determine the best treatment. In most cases, simple measures, medications, and procedures are sufficient to relieve symptoms.
Depending on the stage of hemorrhoids, our clinic offers several modern treatment methods:
- hemorrhoid ligation — placement of rubber bands to cut off blood supply;
- hemorrhoid sclerotherapy — injectable treatment for bleeding hemorrhoids;
- laser hemorrhoid surgery — faster recovery and fewer complications;
- surgical hemorrhoid removal.
Anal Fissure
An anal fissure is a tear in the lining of the anal canal that causes pain during bowel movements and subsequent bleeding. It is often accompanied by itching and burning in the anal area, and some patients may develop fear of defecation due to pain. Anal fissures can occur at any age and are approximately twice as common in women as in men.
Conditions that may cause anal fissures include:
- constipation and hard stools;
- diarrhea;
- inflammatory conditions of the anal canal;
- mechanical injury;
- childbirth.
Damage to the mucosa leads to inflammation, often worsened by spasm of the anal sphincter. As a result, blood supply decreases and the fissure may become chronic. Anal fissures are classified as acute (less than 6 weeks) or chronic (more than 6 weeks). Without timely treatment, complications such as anal abscesses, fistulas, and anemia caused by recurrent bleeding may occur.
Diagnosis is usually straightforward. It includes discussion with the patient, visual examination, and digital rectal examination. If necessary, colonoscopy and biopsy may be used to exclude other diseases with similar symptoms.
In 85% of cases, anal fissures heal on their own with conservative treatment. Treatment options include:
- warm sitz baths (40 °C) for 10–15 minutes, 2–3 times daily;
- a high-fiber diet and sufficient fluid intake (2–2.5 liters daily);
- creams that relax the anal sphincter.
Suppositories are not recommended for anal fissure treatment because they may trigger sphincter spasms and further traumatize the fissure.
If the fissure does not heal despite conservative treatment or becomes chronic, injections into the internal anal sphincter may be used to relax the muscle and promote healing. In some cases, surgical treatment is necessary.
Removal of Anal Skin Tags
Small skin folds around the anus often appear after hemorrhoids, thrombosis, or inflammation. Although harmless, they may cause itching, irritation, and hygiene difficulties.
When Should You See a Doctor?
- Skin folds remain after hemorrhoid treatment
- Difficulty maintaining anal hygiene
- Itching, irritation, or discharge
- Friction or discomfort during movement
Procedure
A simple outpatient procedure performed under local anesthesia — completely painless.
- Duration: approximately 20–30 minutes
- Wounds heal naturally without stitches
Pilonidal Sinus
Pilonidal sinuses are chronic inflammatory abscesses that develop in the cleft between the buttocks. The most common cause is ingrown hairs (sinus pilonidalis: pilus = hair, nidus = nest). Hair grows beneath the skin, bacteria enter, and an abscess forms that the body cannot eliminate on its own.
Three Forms
Mild Form
Almost invisible externally, with only a few small skin openings.
Acute Abscess
Red, swollen, and very tender; causes pain while sitting or walking; discharges pus and blood.
Chronic Form
Does not cause acute symptoms but produces persistent blood-stained discharge.
Risk Factors
- Excessive body hair
- Heavy sweating combined with tight underwear
- Weakened immune system
- Prolonged sitting
- Smoking
- Hereditary predisposition
When Is Proctological Surgery Necessary?
Sometimes conservative treatment for anal and rectal diseases is ineffective, and surgical treatment is indicated. We perform operations in our day surgery department under general or local anesthesia.
Laser Treatment for Hemorrhoids — LHP and HELP
Laser treatment is a modern minimally invasive method for treating internal hemorrhoids (usually stage II–III). Minimally invasive means that no tissue is removed. Compared to traditional surgical excision, recovery is significantly faster and less painful.
LHP (Laser Hemorrhoidoplasty)
During the procedure, laser energy causes coagulation of blood vessels and controlled thermal damage, resulting in shrinkage of hemorrhoidal tissue.
HELP
HELP laser technology targets the arteries supplying blood to hemorrhoids. Once blood flow is interrupted, the hemorrhoids shrink naturally.
Laser treatment is recommended if hemorrhoids cause severe pain, itching, bleeding, or no longer respond to other treatments (creams, suppositories, or ligation). Since the laser works precisely in deeper tissue without damaging the mucosa or anal opening, healing is faster and less painful than traditional surgery.
How Does Laser Hemorrhoid Treatment Work?
A thin laser fiber is inserted into the hemorrhoidal node through a small opening.
Laser energy:
- closes the blood supply to the hemorrhoid;
- causes controlled thermal damage;
- shrinks and reduces the hemorrhoidal tissue.
Advantages of Laser Treatment
- Preserves anal anatomy and function
- Does not damage rectal mucosa or sphincter muscles
- Faster and less painful recovery compared to traditional surgery
- Lower recurrence risk compared to conservative treatment
- Procedure duration: approximately 35–45 minutes
When Is Laser Hemorrhoid Surgery Needed?
Surgery is recommended if:
- previous treatments (ointments, banding, minimally invasive procedures) have failed;
- symptoms recur after previous treatment;
- hemorrhoids prolapse with every bowel movement and no longer retract spontaneously;
- other treatment methods are unsuitable or impossible;
- the hemorrhoids are large and cause persistent discomfort.
Laser Treatment of Pilonidal Cyst (Sinus)
Laser treatment is an innovative procedure for pilonidal sinus disease. The cyst tissue is treated with a minimally invasive laser device requiring only a small incision.
How Does Laser Treatment Work?
A laser fiber is inserted into the fistula tract to:
- close inflamed tissue;
- destroy sinus epithelium;
- promote closure of the tract from the inside.
Laser energy is precisely controlled and primarily affects diseased tissue.
Advantages of Laser Treatment
- minimally invasive (minimal skin trauma);
- less pain compared to conventional surgery;
- rapid recovery (often within 1–2 weeks);
- suitable for complex or branching tracts.
Surgical Removal of Hemorrhoids
Hemorrhoidectomy is a surgical procedure used to remove hemorrhoidal tissue. It is performed when hemorrhoids cause severe pain, itching, bleeding, or no longer respond to conservative treatment.
Hemorrhoidectomy is performed under general anesthesia.
When Is Surgical Removal Necessary?
Surgery is indicated if:
- previous treatments have not helped;
- symptoms recur after treatment;
- stage IV internal hemorrhoids are present;
- other treatment options are unsuitable or impossible;
- the hemorrhoids are large and the patient prefers a one-stage solution.
Surgical Treatment of Anal Fissure
Fissurectomy is a surgical procedure during which the anal fissure is removed. Surgery is performed when the fissure no longer heals with conservative treatment and causes pain, bleeding, or inflammation.
The procedure is performed under anesthesia. During surgery, the edges of the fissure are removed. If necessary, the procedure may be combined with botulinum toxin injections or plastic reconstruction of the defect.
When Is Surgery Necessary?
Surgery is needed if:
- the fissure does not heal with conservative treatment;
- persistent pain or bleeding occurs;
- the fissure repeatedly recurs;
- chronic inflammation or scar tissue develops.
Surgical Treatment of Anal Fistula
An anal fistula is a small inflammatory tract between the rectum and the skin that causes purulent discharge, pain, and recurrent infections. Abscesses may develop and require drainage.
Surgical treatment depends on the location and anatomical characteristics of the fistula tract. Treatment is complicated because the fistula often passes through the anal sphincter, making complete removal impossible due to the risk of fecal incontinence. Multiple surgeries may sometimes be required. Recurrence may occur even after surgical treatment.
When Is Surgery Necessary?
Treatment of anal fistulas is always surgical. Spontaneous healing is extremely rare.
Timely surgery helps prevent chronic inflammation and recurrent abscesses while restoring normal tissue healing.
Surgical Removal of Lower Rectal Polyps
Polyps of the anal canal and lower rectum can be surgically removed. Depending on their size and location, the procedure may be performed under local or general anesthesia. All removed polyps are sent for histological examination. Removal of adenomatous (precancerous) polyps helps prevent colorectal cancer.
When Is Surgery Necessary?
Surgery is necessary if:
- the polyps cannot be removed endoscopically;
- the polyp causes symptoms.
Please see our price list for treatment costs.