You may be referred to Colorectal Surgeon Phoenix — also called a proctologist — for many conditions related to the colon and rectum. Surgical treatment is often required for polyps that aren’t benign or cancerous and for inflammatory bowel diseases, including ulcerative colitis.

Your doctor will ask you about your symptoms and do a physical exam. They may also request diagnostic tests.

Diagnosis

Colorectal surgeons have a unique understanding of the physiology of the intestinal and anorectal tracts, which allows them to diagnose conditions with delicacy and treat them with precision. They know the symptoms and causes of a range of conditions that affect the colon, rectum, and perianal area—from benign issues like hemorrhoids and IBS to inflammatory bowel disease, rectal cancer, and more.

To determine the cause of your GI issues, your doctor will take a full medical history and perform an exam. They may also order blood work, X-rays, CT scans, or an ultrasound to gather important information about the structure of your colon and pelvic organs. MRIs, which provide detailed images of the colon, can help identify tumors and other abnormalities as well as assess how close they are to other anatomical structures.

If the results of these tests are inconclusive or if they show an abnormality, your doctor will recommend a colorectal surgery procedure to get a more accurate diagnosis. They can choose from a variety of minimally invasive surgeries, such as a colonoscopy or laparoscopic procedures.

A colonoscopy is a procedure that enables the doctor to see the inside of your large intestine and anus using a lighted tube with a camera attached to its end. This allows the surgeon to identify problems such as anal bleeding, abdominal pain, and unexplained weight loss. They can also use the tube to take tissue samples or remove polyps, which helps them make an official diagnosis.

During this type of surgery, the patient is under general anesthesia, and three to five tiny incisions are made in the lower abdomen. Gas is pumped in to create space and improve visualization, and the surgeon inserts a small camera into one of the incisions. They can also insert instruments through other incisions to remove diseased sections of the colon or excise growths and tumors.

If it’s not possible to reconnect healthy parts of the colon and rectum after a colectomy, the surgeon will create an opening in the abdomen that’s called an ostomy, which allows stool to leave the body through this new opening. This can be temporary or permanent, depending on the condition of the colon and rectum.

Treatment

Unlike gastroenterologists, colorectal surgeons treat conditions related to the lower colon and rectum. They also perform surgical procedures involving the anus and pelvic floor, as well as hemorrhoids. You may be referred to a colorectal surgeon by a gastroenterologist (specialist in gastrointestinal diseases) if you have polyps that can’t be removed endoscopically, or if you have a disease of the lower colon that requires surgery to manage.

In addition to running diagnostic tests, such as colonoscopies and sigmoidoscopies, colorectal surgeons also perform laparoscopic and robotic surgeries to treat conditions that affect the colon, rectum, anus, and pelvic floor. They specialize in complex reconstructive procedures, such as creating new pouches of intestinal tissue to replace diseased sections of the colon and rectum that have been removed due to cancer or other conditions.

They use minimally invasive techniques to reduce postoperative pain and shorten hospital stays. These include laparoscopy, which uses small abdominal incisions to insert a long, thin lighted tube with a camera (laparoscope) that allows your surgeon to see the affected area and operate. They also offer endoscopic mucosal resection, or EMR, and endoscopic submucosal dissection (ESD), both advanced endoscopic techniques that are used to remove tumors, polyps, and other abnormalities.

After your operation, you will probably stay in the hospital for two to three days. During this time, you’ll take medications to control pain; pass stool; and empty your bladder frequently. You may feel fullness, gas, and cramping for a while, but these symptoms should improve with time.

After your recovery, you’ll be able to return to your normal activities. Your doctor will probably recommend lifestyle changes, such as dietary and exercise modifications, to help prevent further problems in the future. If your surgery was to manage a disease, such as cancer, you’ll need ongoing monitoring and testing. You may need to take medications, and your doctor might suggest that you have regular follow-up colonoscopies or sigmoidoscopies. Depending on the condition, you might need to have an ostomy, which creates a hole in your abdomen so that waste can be removed directly rather than through the rectum and anus.

Recovery

Your surgeon may prescribe laxatives or enemas to empty your colon before surgery. Then they’ll give you a general anesthetic, which puts you to sleep. Next, nurses will clean you and drape your abdomen with sterile sheets. Your surgeon will make 1 long incision or several small ones (surgical cuts). They’ll remove the part of your colon that has cancer and some normal colon on either side of it. They might also remove nearby lymph nodes. Then they’ll reconnect your colon and rectum.

Depending on the stage of your cancer, you might need additional treatments, such as chemotherapy or radiation. These might be given before or after surgery to kill any remaining cancer cells. Your surgeon might also recommend a procedure to relieve symptoms, such as removing a colon blockage or relieving pain.

If your colorectal cancer has spread to the liver or lung, you might need other treatments, such as a combination of surgery and chemotherapy. Your surgeon might try to take out the polyps and small tumors that haven’t spread during a colonoscopy or through laparoscopy, in which they put special tools and a camera into your belly through small cuts. If these don’t work, they might need to remove more polyps and a section of your colon and rectum (partial colectomy).

You may be able to go home after a few days in the hospital. The length of your stay depends on whether your pain is controlled with medications and you can walk without discomfort, eat without nausea, and pass gas.

Before surgery, your doctor will ask you about your medical history and do a physical exam. They might order tests to check your blood pressure, heart rate, and oxygen levels. These might include an EKG, chest X-ray, or lung function test.

You should also ask your surgeon questions about their education, training, and experience. It’s especially important to find out how often they treat people with your type of colon cancer and what their success rate is. You should also ask about any follow-up appointments and what to expect at each one.

Follow-Up

The surgeon will ask you about your health history and perform a physical exam. You may also be asked to provide a blood sample and undergo a chest X-ray, lung function tests, and an EKG (electrocardiogram). A colonoscopy or sigmoidoscopy will then be performed, during which a flexible lighted camera will be inserted into the colon or lower third of the colon to take pictures and biopsies. Polyps can also be removed during these procedures. You will be given bowel-cleansing instructions to prepare for these procedures. They are usually performed as outpatients at surgery or endoscopy centers.

The surgical site may be tender for some time. This will gradually improve as the body heals. The cancer recurrence rate is highest within the first five years after surgery, so follow-up is very important for patients with colorectal cancer.

Two patterns of recurrence are recognized: local and distant. A true local recurrence is when tumors develop at the site of the original colorectal cancer in the inner lining of the colon or rectum. Distant recurrence is when cancer cells spread to sites in the body away from the colon or rectum, most commonly the liver and lungs.

Many medical societies and expert groups recommend intensive postoperative surveillance after colorectal surgery to detect a recurrence at an early stage when it is likely still resectable. This involves more frequent follow-up, including hemoglobin and pylorus (pH) testing, CEA, CT scans, and colonoscopy.

Your doctor will discuss your follow-up schedule with you. How often you need to go to the clinic will depend on what type of treatment you receive and how well you recover. It is important to keep all follow-up appointments, but you may need to come less often as your condition improves. Between appointments, you should let your doctor know immediately if you notice any changes in your symptoms or health problems.

Our colorectal surgeons work closely with other cancer specialists, such as radiation oncologists and medical oncologists, and with radiologists and pathologists to develop a comprehensive treatment plan for each patient. This team approach ensures that the right treatments are given at the most appropriate time, leading to better outcomes.