Colorectal Surgeon Phoenix (also called a proctologist) specializes in conditions that affect the colon, rectum and anus. Your primary care physician often calls these doctors for diagnosis and treatment.
Surgery to correct these conditions can involve either nonsurgical procedures or surgical techniques. Surgery may include complete removal of the colon or the creation of a stoma that allows waste to pass from the abdomen through a bag outside the body.
Hemorrhoids are enlarged blood vessels in and around the anus and lower rectum. They can form from overly tight clothing or sitting on the toilet for extended periods. Often, hemorrhoids can be treated with over-the-counter creams or ointments that relieve symptoms and may prevent them from returning. However, these treatments do not cure the problem, and it is important to see a colorectal surgeon for a thorough evaluation and treatment plan to resolve your hemorrhoids once and for all.
Hemorrhoid pain is usually caused by straining during bowel movements or sitting on the toilet for too long. This puts pressure on the veins in the rectum and causes them to swell and create a painful bump. You may also have itching, bleeding, or a feeling of incomplete emptying of your stool. A physician will diagnose hemorrhoids based on your history and physical exam. They will recommend the best course of treatment based on your symptoms and lifestyle.
There are two types of hemorrhoids: internal and external. External hemorrhoids are on the outside of your anus, so they are visible and often irritate the rectal area with their rough texture. Internal hemorrhoids are inside your rectum, behind the anus, so they aren’t as visible and typically hurt less because there are fewer sensitive nerves in this area. Hemorrhoids can become infected, bleed and recur or prolapse.
When hemorrhoids are severe, prolapsed or thrombosed, your doctor may need to perform a procedure called hemorrhoidectomy. This involves making a narrow incision around the hemorrhoids and cutting off the blood vessels. This surgical procedure is the most effective way to treat hemorrhoids and prevent them from reoccurring.
In rare cases, a doctor might suggest anesthesia for this procedure. However, this is only done when the condition is so severe that it threatens your ability to have a bowel movement. The doctor will make sure the incision is made as low as possible to reduce the risk of damage to the sphincter that controls your bowel movements. A patient should avoid aspirin and non-steroidal anti-inflammatory drugs for 10 days before the procedure to ensure proper healing.
Inflammatory Bowel Disease (IBD)
The chronic inflammatory diseases Crohn’s and Ulcerative Colitis often necessitate surgical treatment. Whether you suffer from one of these conditions or both, your colorectal surgeon has several surgical options to treat the inflammation and restore normal functioning.
Crohn’s Disease and Ulcerative Colitis are autoimmune disorders, meaning your body’s immune system mistakenly attacks healthy tissues within the digestive tract. This causes abdominal pain, bloody diarrhea, and sometimes colon cancer. While genetics plays a significant role in these conditions, the exact cause of IBD remains unknown.
Symptoms of IBD include abdominal pain, bloody diarrhea and occasional rectal bleeding. Patients with IBD also have a higher risk of developing colorectal cancer and colon polyps. These patients should receive surveillance colonoscopies every one to two years. These procedures will include a series of biopsies, which are small tissue samples taken for microscopic examination. If dysplasia, or precancerous or cancerous cells, are found, surgery may be required to remove the entire colon and rectum.
A specialized technique used in IBD surgery is resection of the colon with laparoscopic techniques, which minimizes the amount of intestinal loss. These procedures are usually performed for Crohn’s Disease patients with long-standing inflammation involving more than a third of the colon and those who have a history of a previous colectomy.
Other complications of IBD include strictures, which are areas of narrowing in the bowel, and fistulas, which are abnormal passageways that connect organs or vessels that normally do not connect. Fistulas develop as a result of long-term inflammation, causing bowel contents to leak into the bladder, urethra or vagina. This can lead to serious infection and a reduction in quality of life.
Managing your IBD requires a multidisciplinary team of doctors and nurses who understand the disease and its complications. Patients with IBD should see their gastroenterologists to optimize medical therapy before seeking surgery. They should also be evaluated by a colorectal surgeon to assess the need for surgery and the best surgical procedure. If you are considering surgery, make sure to research your surgeon’s experience, training and qualifications. You can ask your gastroenterologist or other doctors for recommendations and find surgeons on websites like the American Society of Colon and Rectal Surgeons.
Colorectal Cancer
Colorectal cancer is a type of cancer that starts in the large intestine (colon). It may also begin in the lower part of the rectum but is usually found in the colon. Most colorectal cancers start from non-cancerous growths called polyps. These can be found during screening or during a procedure called a colonoscopy. Sometimes, polyps are pre-cancerous and can be removed to prevent them from becoming cancer. Having more polyps or a family history of colon cancer increases the risk of developing colorectal cancer.
If cancer is diagnosed, treatment includes surgery, chemotherapy and radiation therapy. A multidisciplinary team of doctors works together to provide the best care for patients with colorectal cancer.
Some people with colorectal cancer need to have surgery to remove the tumor and nearby lymph nodes. This surgery is often done with minimally invasive surgery, which reduces the amount of time spent in the hospital and decreases complications.
A stent (a small tube) can be put in the colon to stretch and hold it open, if the cancer has blocked the colon. This can relieve symptoms and help prepare the colon for surgery. The stent is usually done for a short period of time and can be removed or replaced as needed.
Colon cancer can also spread to other parts of the body, so it is important to have regular screenings. If cancer is detected early, it is easier to treat and survives better.
Incidence and death rates for colorectal cancer have been decreasing in high-income countries, mainly because of improved screening and treatment. Having a family history of the disease, a diet that is high in red and processed meat and low in fiber, calcium, and fruits and vegetables, and being overweight or sedentary all increase the risk of colorectal cancer.
If a person’s colon cancer has spread, surgery to remove the affected area is done through a long incision in the abdomen (belly). This is known as an open colectomy. If the entire colon is removed, it’s called a total colectomy. Less invasive surgical methods to remove the colon include laparoscopic and robot-assisted surgery.
Endoscopic Surgery
Your large intestine (colon) is the final stop for food on its trip through your digestive system. Your doctor might use a surgical procedure called endoscopic surgery to examine the colon and fix problems. This technique uses a scope—a long, thin tube with a camera and light at its tip. Unlike traditional open surgery, it does not require major incisions and causes less pain, discomfort, and scarring.
For an upper endoscopy, your surgeon inserts the scope into the mouth and throat to get a view of the esophagus, stomach, and part of the small intestine. You might have an endoscopy to diagnose or treat a condition such as gastroesophageal reflux disease or peptic ulcers. Your surgeon can also remove a lesion or polyp from the lining of your esophagus, perform a biopsy on a lump in your stomach, or repair a hole (perforation) in your duodenum or stomach that might cause bleeding.
You may have an endoscopy to treat a symptom such as abdominal pain or blood in your stool. The procedure takes about an hour, and you stay under observation or under sedation for a short time afterward. Some endoscopic procedures involve minor surgery, for example, placing a stent to relieve a blockage in the colon or removing a cyst from your gallbladder.
A colonoscopy can detect cancer and other problems. If you have a tumor, your surgeon can insert an instrument called a snare—a wire rope like a lasso—through the endoscope and loop it around the tumor. Then, your surgeon can apply electrical current to cut the tumor away, piece by piece.
Other surgical procedures performed endoscopically include fistula treatment (repairing a tear or hole in your colon, anus, or rectum), J-pouch surgery (treatment for ulcerative colitis in which the large intestine and anus are removed and a J-shaped bowel is created for passing stool), and endoscopic mucosal resections. Some endoscopic surgeries use a robotic device, which gives your surgeon better control and precision and allows you to heal faster with less scarring. The robot is also used for a procedure called laparoscopic surgery, which lets your doctor operate on organs through tiny incisions instead of opening up a large opening in your body.