The question of whether the medical specialty known as proctology still exists is common, and the answer involves a change in professional terminology and scope. Historically, the term “proctology” referred specifically to the study of the rectum and anus, derived from the Greek words proktos (meaning “anus” or “hindparts”) and logia (meaning “study”). Today, the field and the doctors who practice it are still very much present, but the name has been updated to reflect a broader range of expertise.
The Evolution of Proctology to Colorectal Surgery
While the term “proctologist” is still occasionally used by the public and sometimes by the physicians themselves, it is largely considered an outdated title within the medical community. The modern, preferred title for this specialist is “Colorectal Surgeon” or “Colorectal Specialist.” This change in nomenclature, which began to take hold in the late 20th century, reflects a significant expansion of the specialty’s focus.
The original field of proctology concentrated on conditions affecting only the rectum, anal canal, and perianal area. The current designation of “colorectal surgery” encompasses the entire large intestine, which includes the colon, the rectum, and the anus. This broader scope ensures that these specialists are fully trained in the surgical and medical management of diseases throughout the lower gastrointestinal tract.
For example, the American Proctologic Society, founded in 1899, officially changed its name to the American Society of Colon and Rectal Surgeons (ASCRS) in 1973. This name change formalized the expansion of the specialty’s purview. The shift acknowledges the interconnected nature of the large bowel and the diseases that affect the entire colon.
Common Conditions Treated by Colorectal Specialists
Colorectal surgeons treat a wide array of conditions, ranging from common, benign issues of the anorectal area to complex diseases of the colon. A common group of ailments they manage includes benign anorectal problems that cause pain or discomfort.
These specialists frequently treat hemorrhoids, which are swollen veins in the rectum and anus that can cause bleeding or pain. They also manage anal fissures, which are small tears in the lining of the anal canal that result in sharp pain, and anal fistulas, which are abnormal tunnels connecting the anal canal to the skin. Other conditions in this category include abscesses, pilonidal cysts, and chronic itching of the anus.
Moving beyond the anorectal area, colorectal specialists manage serious and complex diseases of the colon and rectum. They are central to the diagnosis and treatment of colorectal cancer, including the surgical removal of cancerous tumors and precancerous polyps. Their expertise is also directed toward inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, which may require surgical intervention when medical therapies fail.
They treat conditions like diverticulitis, where small pouches in the colon wall become inflamed or infected, often necessitating surgery to remove the affected segment. They also address issues like fecal incontinence, constipation, and rectal prolapse, using their specialized knowledge of intestinal and anorectal physiology to restore function.
Qualifications and Board Certification
Becoming a board-certified colorectal surgeon requires a substantial commitment to specialized medical training that goes well beyond general practice. The process begins with four years of medical school, followed by a rigorous, five-year residency program in general surgery. This initial phase provides a foundational understanding of various surgical disciplines.
After completing the general surgery residency, the physician must complete an additional one-year fellowship specifically focused on colon and rectal surgery. This dedicated training provides in-depth knowledge of the medical and surgical management of diseases affecting the intestinal tract, colon, rectum, and anus. During this fellowship, they acquire specific skills in areas like minimally invasive abdominal surgery and endoscopic procedures.
To achieve board certification, the specialist must pass a series of comprehensive examinations administered by the American Board of Colon and Rectal Surgery (ABCRS). Candidates must first be certified by the American Board of Surgery before they can take the exams for colorectal surgery. This dual certification process ensures a high standard of skill and knowledge for treating both simple and complex conditions of the lower gastrointestinal tract.