What Does A Colorectal Surgeon Do?
Many people know what a general surgeon does, but few are familiar with the specialties within surgery. A general surgeons’ main job is to perform all sorts of surgeries, from simple procedures such as cleaning wounds or fixing broken bones to more complex ones like brain or spinal cord surgery.
However, not every doctor specializes in general medicine. Some focus only on certain areas of internal medicine, for example, colonoscopy (an examination of your digestive tract) and gastroenterology (digestive diseases). Or perhaps they have their own area of expertise, such as vascular (relating to blood vessels) or thoracic (chest related) surgery.
Some specialists develop additional skills that make them very effective at treating patients. For instance, someone who is good at heart surgery may also learn how to do open-heart surgery. This way he or she can both treat each other as well as cardiac conditions!
The term “surgery” applies equally to all these different fields. Therefore, even if a doctor doesn't specialize in colorectal disease, they might be able to help you by doing something related to this area of medicine. For example, a cardiologist could give you advice about weight loss or nutrition, a GI specialist could look at how to manage your symptoms, and an ear, nose, and throat (ENT) physician could suggest ways to improve your voice quality.
Examine the colon
During your visit, your colorectut surgeon will look in and examine the whole of the colon. This includes looking at it through a special tool called a sigmoidoscope that has a light attached to it so they can see inside the rectum and anus.
The doctor also looks for any blood or fluid coming from the anal area, which may indicate an internal injury or disease.
If there are no symptoms but you have had some changes in bowel habits or passing of stool, then this test helps identify if anything is wrong with the colon. It does not determine whether things like cancer happen, however.
That would require further tests such as a biopsy, where small samples of tissue are taken for examination under a microscope.
Examine the rectum
During your colonoscopy, your doctor will be looking to examine the internal lining of the large intestine (the bowel). This is called examining the mucosa or surface layer of the gut.
If you’re over 40 years old, it’s possible that the normal changes in the mucosal layer can be difficult to identify. That’s because as people get older, the protective coating around some of the cells may thin out or even disappear.
This makes it more likely for abnormal tissues like polyps to grow undetected. If this happens, then cancer could progress unnoticed.
Fortunately, with advanced imaging technology, such as chromoendoscopic (or “chromo-” means color; endoscope means scope) light therapy and narrow band laryngoscopy, early detection is now feasible.
Chromoendoscopic light therapies use special filters to better visualize certain parts of the digestive system. Narrowband laryngoscopy uses an oral airway device with very fine slits at the tip to directly view the vocal folds, the tissue that produces sound when we speak.
These technologies have great success rates in detecting precancerous lesions and sometimes finding small cancers too.
Examine the appendix
Most people have an understanding of what an internal medicine doctor does, but few know what a colorectal surgeon actually is. A colorectal surgeon is a generalist physician that specializes in surgery to treat symptoms of your digestive system.
They are not only trained in looking at intestines for problems, but also how to perform minimally invasive surgeries or procedures directly on the surface of the abdomen. These surgeons can perform both diagnostic (looking into disease) as well as therapeutic (fixing diseases) procedures.
Their level of training may vary slightly, but most must complete four years of medical school, three more years of residency, and then one or two additional fellowship programs to be considered specialists.
Some specialties require board certification which is similar to becoming a member of the American Board of Medical Specialities.
Examine the ileum
After the colon, next in order of entry is the small intestine or jejunum, followed by the large intestine or rectum. The term “colon” refers to the first part (or proximal) of the large intestine — the stomach’s descending limb. It is here that digestion usually stops!
The next area of the digestive tract you will learn about is the ileum. This is a very important region of your gut because it acts as a kindy barrier between what goes into the GI system and what comes out.
Ileus can occur when there is an obstruction anywhere along this short segment of bowel. An obstruction here means something gets stuck inside the intestines and cannot move easily.
This may be due to inflammation, disease, or abnormal growth of tissue. In some cases, people develop food allergies after experiencing intestinal obstructions in their ileum.
If you are ever diagnosed with IBS, irritable bowel syndrome, then your doctor might do testing for food sensitivities in the ileum. These tests look at how your body reacts to certain foods and determine if anything is causing symptoms.
Examine the cecum
When performing an exploratory laparotomy, or surgical opening of the abdomen, it is important to also examine the right side of the colon known as the ascending colon, the transverse colon, and then the descending colon. This is called the Morrison approach to surgery because the surgeon performs this sequence in order.
The next part of the exam looks for specific symptoms that could indicate more serious health issues such as blood in your stool, pain when eating, weight loss, etc. If these are present, then further testing and possible treatments can be done immediately.
However, if there are no signs of disease after this inspection, then patients usually feel better knowing they have been diagnosed and treated early. It is very common for people to feel relieved after being informed of their diagnosis, and while not every patient needs immediate treatment, it is always best to know what all of your options are before deciding which one you will go with.
Examine the ascending colon
After completing an exam of the transverse colon, the surgeon moves up to examine the descending or sigmoid colon. This is called the ascending (upward) colon examination.
During this procedure, your doctor will look for potential polyps in the colon. If there are any abnormal growths found, they can be removed immediately.
Most people do not require surgery at this time unless you have symptoms such as blood in stool or frequent stomach aches.
However, it is important to remember that most patients with irritable bowel syndrome (IBS) go on to develop colitis or other digestive issues after undergoing pro-colon procedures. IBS is caused by inflammation of the intestines so if you suffer from IBS, it’s crucial to make sure you don’t have any more intestinal surgeries until your health has fully recovered!
Procedures like a colectomy may be necessary for patients who have repeated bouts of severe ulcerative colitis or Crohn's disease.
Examine the transverse colon
During your coloscopy, one of the first things we look at is the transverse colon. The transverse colon acts as a buffer between food that has been processed in the stomach and what gets digested in the intestines.
If you’ve noticed blood during a bowel movement or diarrhea, it may be due to inflammation of the transverse colon. This can occur when there are symptoms of IBS (irritable bowels syndrome), celiac disease, inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis, or irritants like bile that get absorbed into the digestive system.
Certain foods can also contribute to inflammation of the transverse colon. Luckily, most people have an adequate amount of acid in their gut to help break down certain foods so only experiencing discomfort for a few hours with a meal.
For individuals who suffer from frequent bouts of constipation or diarrheaafter eating a particular food, they may need to modify their diet to avoid this potentially harmful substance.
Examine the descending colon
After washing and drying the patient, your surgeon will carefully inspect each area of the abdomen to look for symptoms or signs of colitis. They may also perform an exam called a proctoscopy, where they check out the rectum and anus with a special device. This is done to make sure there are no changes in the appearance or function of these areas due to intestinal inflammation.
During this procedure, the doctor will also examine the bowel by looking at it through a small camera that can be inserted into the rectum. If necessary, biopsies can be taken to determine if inflammatory cells have invaded the tissue and begin acting as a catalyst for infection.
These tests help confirm a diagnosis of IBD and rule out other conditions that can cause similar symptoms.
After his surgery, my patient was able to return to work within one week! He now takes a two-month break from work during the winter so he does not need to take time off for recovery.