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Proctology

Proctology is the field that deals with the examination, diagnosis and treatment of acute and chronic diseases of the anal canal, perineum and bowel. Many patients avoid to consult a proctologist, because of shyness or lack of information. But an examination on time is vital, especially if you are in the risk category or you notice some disturbing symptoms.

At Medpark you benefit from the best solutions because we offer you in the same place and at the best conditions: specialized consultancy, laboratory investigations and imaging, minimally invasive procedures, surgical and hospital treatment. Proctology consultations and interventions are carried out by dr. Iurii Serbulenco and covers a wide range of pathologies: internal and external hemorrhoids, anal fissures, pararectal fistulae, acute paraproctitis, rectal polyps, etc.

You need a proctologic consultation if you have at least one of the following symptoms:
  • Bleeding, mucus and / or pus leakage from the anal canal;
  • Pain in the anal region during defecation and afterwards;
  • Sensations of weight and discomfort in the perineum;
  • Prolapsing and / or occurrence of some formations in the perianal area;
  • Bloating and abdominal pain;
  • Constipation, diarrhea, flatulence, difficulty in defecation;
  • Unexplained decrease in body wight, lack or loss of appetite;
  • Age of over 50 years, especially if your relatives have malignant diseases, not only of the bowel;
  • In particular, you should be alerted by the permanent bleeding, permanent impulse to defecate, constipation alternating with diarrhea, weight loss, general weakness.
Proctologic disorders and proposed treatments

The most common disorders of the anal canal are hemorrhoids and anal fissures.

Hemorrhoids – although it is a common condition, it should not be neglected. The disease affects mainly those who do hard physical labor, people suffering from chronic constipation, pregnant women, people with a sedentary lifestyle.

Hemorrhoidal disease includes all clinical manifestations of pathological changes of hemorrhoids (bleeding, prolapsed haemorrhoidal nodules, thrombosis of internal, external nodules etc.), but hemorrhoidal nodule detection in the absence of complaints cannot be considered a disease.

Hemorrhoids are manifested by bleeding of different intensity during the act of defecation and by prolapsing of internal hemorrhoids.

Hemorrhoids can be acute or chronic, which in fact are different phases of the same disease. There can be detected internal, external hemorrhoids, depending on the dominant element, and combined hemorrhoids.

  • Acute hemorrhoids – by acute hemorrhoids it is understood the thrombosis of hemorrhoids, that manifests through enlargement, swelling of hemorrhoids and pain in the anus, often very intense. Usually these symptoms make the patient address a specialist for the first time.
    There are three degrees of severity of acute hemorrhoids:
  • Grade I is characterized by thrombosis of hemorrhoids without inflammation of the mucous membrane and of the perianal skin.
  • Grade II is characterized by thrombosis of hemorrhoids with inflammation of the mucous membrane.
  • Grade III – the thrombosis with transition to the inflammation of the mucous membrane and perianal skin.

Addressing a specialist in time and an appropriate treatment can solve the case in 4-6 days. Necrotic changes of the perianal tissue can develop in severe cases, with the onset of a purulent perirectal (abscess in the perianal area).

  • Chronic hemorrhoids – the main manifestations are: episodic bleeding, especially when defecating. Bleeding is usually the first sign of the disease, the prolapse of hemorrhoids occuring in the next 5-8 years. At first, the patient can easily reduce it with a simple contraction of the anal muscles. Subsequently, muscle tone decreases and the nodules require manual reduction. The degrees of chronic hemorrhoids are:
  • Grade I – anal bleeding without the prolapse of hemorrhoids.
    Grade II – reduced hemorrhoids prolapse in the anal canal (with or without bleeding).
  • Grade III – hemorrhoids prolapse with periodic need for manual reduction in the anal canal (with or without bleeding).
  • Grade IV – Permanent prolapse of hemorrhoids together with mucous membranes of the rectum, inability to reposition them in the anal canal manually (with or without bleeding).

Treatments for Hemorrhoids

Depending on individual characteristics of the patient and the degree of the condition (I, II, III or IV), your proctologist will choose the most appropriate method of treatment:

  • Conservative treatment: prescription of a diet, limitation of physical activity and prescription of medications that reduces the edema, normalization of the microcirculation in the hemorrhoidal plexus, relieving of the pain.
    Minimally invasive treatment: ligation of internal hemorrhoids with latex rings. The procedure is performed ambulatory, it does not require anesthesia, and the costs are minimal.
  • Surgical treatment: is applied in thrombosis of external hemorrhoids and is performed with local anesthesia. In this case, the isolated removal of the thrombotic masses is performed, as well as the excision of the entire thrombosed node. At Medpark both types of surgeries are performed, the classical hemorrhoidectomy and the surgery by Longo’s procedure.

Anal fissure is a common disease, more common in women, and it is a deterioration of the anal mucosa. At 3-4 weeks after the formation of acute anal fissure, in the absence of appropriate treatment, it becomes chronic.
Visually, the chronic anal fissure differs from the acute one: thickening of margins of the fissure, rough scar tissue and on the distal portion a “guardian polyp” is forming. Pain in patients with chronic anal fissures usually occur after defecation, are less intense than in acute or even absent anal fissures. The bleeding and sphincter spasm persist.

Treatment for anal fissure

In the treatment of chronic anal fissures are used both minimally invasive techniques and surgery. Drug treatment is ineffective, but dietary compliance is mandatory. Enemas, sitz baths and suppositories with Belladonna are indicated.

It is essential to visit a proctologist in time because minimally invasive treatment, non-surgical treatment of fissures is very efficient. When the symptoms described above occur, in order to concretize the diagnosis it is necessary to exclude secondary anal fissures in case of tuberculosis, syphilis, rectal cancer etc.

For these and any other proctologic conditions found upon investigations, the proctologist will indicate an individual treatment method.

Reasons to choose Medpark:
  • Experienced medical team;
  • Complex investigations;
  • Diagnosis with great accuracy;
  • The latest conservative treatments;
  • Minimally invasive procedures without hospitalization;
  • Safe surgeries, with modern methods and short recovery period;
  • Efficiency and quality of the treatments.