Colon & Rectal Surgeon: Your Lower Digestive Tract Specialist

Your primary care doctor can take care of your general digestive health and manage certain conditions, such as mild hemorrhoids and occasional constipation or diarrhea. Many people see a colorectal surgeon for the first time when their primary care doctor or another specialist finds or suspects a more complex condition, such as colon polyps or incontinence. Primary care doctors also refer patients to colorectal surgeons for further evaluation of symptoms that may indicate a serious condition. For example, rectal bleeding or unexplained, ongoing constipation or diarrhea can indicate colon cancer or bowel obstruction.

Seeing a colorectal surgeon for early treatment or preventive care before serious intestinal problems occur is the best way to reduce the risk of permanent damage, disability, and other complications. 

Consider seeking care from a colorectal surgeon if you have any of the following symptoms or conditions: 

• Anal or groin area abscess or boil

• Bowel or urinary incontinence

• Rectal bleeding or black stools with a sticky, tarry texture

• Unexplained itching or burning around the anus

• Unexplained or ongoing diarrhea or constipation

• Unexplained or severe abdominal, rectal or anal pain

You should also seek care from a colon and rectal surgeon under the following situations:

• You have a digestive, urinary, or female reproductive system condition or disease that requires ongoing monitoring and specialized care, such as ulcerative colitis or rectal prolapse.

• You need specialized tests or procedures of the intestines such as a colonoscopy.

• Your primary care doctor finds a condition that needs further evaluation, such as blood in your stool or an abdominal mass.

If you need an expert in the digestive system, urinary tract, and female reproductive system, find an experienced, board certified, colon and rectal surgeon.

A colorectal surgeon treats conditions and diseases that involve the health of the intestines and related conditions of the urinary tract and female reproductive system. Conditions they treat include:

• Colon and rectal cancer including polyps, which are precancerous masses

• Diverticulosis, which is the development of pockets (diverticulae) on the wall of the colon

• Fissures, which are painful tears in the anus

• Hemorrhoids, which are swollen veins in the rectum and anus

• Infections around the anus and rectum including abscesses, fistulas, and anal warts

• Inflammatory bowel disease (IBD) including Crohn’s disease and ulcerative colitis

• Pelvic organ prolapse including bladder prolapse and rectal prolapse

• Problems with urination and bowel movements including incontinence, ongoing constipation or diarrhea, and urinary retention

A colorectal surgeon can order or perform a wide variety of diagnostic and screening tests for the conditions of the intestines and digestive organs, as well as the urinary and female reproductive system and general health issues. They also interpret these tests including:

• Barium enema (lower GI series of X-rays) to detect abnormal areas in the colon

• Colonoscopy and sigmoidoscopy to examine the lower portion of the colon (sigmoidoscopy) or the entire colon (colonoscopy)

• Digital rectal examination to feel the anus and rectum for abnormalities and check stool for blood

• General health and screening tests including stool testing for blood and infection, complete blood count (CBC), blood clotting tests, blood culture, urinalysis, chest and abdominal X-ray, blood glucose (sugar) test, electrolyte tests, liver and kidney function tests, and blood pressure screening

• Proctoscopy to examine the rectum using a short, lighted tube called a proctoscope

• Virtual colonoscopy to look for abnormalities of the colon using computed tomography (CT) or magnetic resonance imaging (MRI)

Medical treatments, procedures and surgeries colorectal surgeons perform include: 

• Bowel obstruction repair to remove the obstruction and repair the colon

• Colectomy (colon resection) to remove all or part of the colon

• Colonoscopy with polypectomy to examine the entire colon and remove precancerous growths (polyps)

• Colostomy to allow stool to pass from the large intestine out through the abdomen

• Incision and drainage of abscesses including perianal abscess and pilonidal abscess

• Hemorrhoid removal and other treatments for large, bleeding or painful hemorrhoids

• Medications including antibiotics and anti-inflammatory drugs  

• Pelvic laparoscopy to diagnose and treat a variety of problems of the colon, urinary tract, and female reproductive organs

Your primary care doctor or other specialist may refer you to a colon and rectal surgeon for specialized treatment or surgery. Whether you have a referral or not, choose a surgeon who is board certified in colon and rectal surgery. Board certification is a meaningful component of a doctor’s expertise. It verifies the doctor has completed residency training in the specialty and has passed stringent requirements.

The American Board of Colon and Rectal Surgery (ABCRS) certifies eligible MDs and DOs who have completed subspecialty training in colon and rectal surgery. The Board requires prior certification in general surgery (from the American Board of Surgery).

To maintain board certification in colon and rectal surgery, a doctor must participate in an ongoing certification program.

Keep in mind that a doctor may perform certain colon and rectal surgeries without becoming board certified in the specialty. For example, general surgeons and surgical oncologists perform many types of surgery involving the colon and rectum. In addition, surgeons board certified by the American Osteopathic Board of Proctology specialize in colon and rectal surgery. Most of these providers prefer the term colon and rectal surgeon rather than proctologist.

Talk with your doctor about the best type of specialist for you. It may depend on how complex the surgery is that you need. When considering a colon and rectal surgeon, ask him or her to provide details about the training and experience they have with the specific treatment you need. Also consider the quality of surgical care at the hospital where the surgeon practices.