“What does a colorectal surgeon do?” is a question often asked by patients who need treatment for colorectal problems.
Colorectal surgeons are specialists in their field who treat, diagnose, and perform surgery on multiple conditions affecting the lower gastrointestinal tract. Also known as the GI tract, this part of the digestive system comprises the large intestine, colon, and anus.
Often, colorectal surgeons also work alongside gastroenterologists to treat conditions affecting the entire GI system. They may perform similar procedures and manage similar conditions.
When Should You Visit A Colorectal Surgeon?
A patient will typically consult a colorectal surgeon if they experience symptoms affecting their GI tract. Many patients start by seeing a general physician or gastroenterologist, who will later refer the patient to a colorectal doctor.
Medical conditions that will likely require treatment by a colorectal surgeon include:
- Inflammatory Bowel Disease (IBD)
- Colorectal cancer and polyposis
- Peritoneal carcinomatosis
- Hereditary nonpolyposis colorectal cancer (HNPCC)
- Anal cancer
- Appendix cancer
- Anal fistulas
- Rectal prolapse
- Perianal abscess
- Ischemia (blood supply loss)
- Diverticular disease
- Ulcerative colitis
- Crohn’s disease
- Rectal bleeding
- Anal warts
- Rectal bleeding/gastrointestinal bleeding
Do Colorectal Surgeons Treat Conditions That Affect Only The Large Intestine?
While colon and rectal surgeons specialise in the large intestine, they also perform advanced general surgery.
Most of our body’s organs affect each other — this is why colorectal surgeons may often treat other organs closely linked with the large intestine or share the same conditions.
Other organs which a colorectal surgeon may treat include:
- Urinary tract
- Small intestine
What Qualifications Does A Colorectal Surgeon Have?
Board-certified colon and rectal surgeons will at least have completed a five-year training program in general surgery and additional training at an ACGME-accredited (Accreditation Council for Graduate Medical Education) colon and rectal surgery residency.
In addition to their proficiency in general surgery, colon and rectal surgeons also have specialised skills in performing endoscopies of the rectum and colon. They can also perform anorectal physiology techniques to examine and diagnose anal sphincter and pelvic floor disorders.
Many colorectal surgical residency programs offer training in minimally invasive surgery of the abdomen, including the rectum and colon.
What's The Difference Between A Colorectal Surgeon And A General Surgeon?
The primary difference between a general and a colorectal surgeon is the level of depth and knowledge in treating specialised conditions.
General surgeons are typically trained in general GI tract surgery. Meanwhile, a colorectal surgeon has received in depth training in bowel surgery, especially in the colon and rectum.
General surgeons are available in many public hospitals and centres. While you can still find a colorectal surgeon in public health centres and communities, many opt for private practice.
3. Minimally Invasive Surgery
In urgent cases, a general surgeon is less likely to perform laparoscopic surgery than a colorectal doctor. The latter can comfortably perform minimally invasive surgery, especially for patients requiring emergency attention.
This is because they have a professional understanding and experience in advanced IBD principles and techniques, which a general surgeon does not have.
What Techniques Do Colorectal Surgeons Use?
Colorectal surgeons use various surgical and endoscopic techniques to treat their patients’ GI tracts. They have all the right equipment and tools to treat complex conditions, either through endoscopy, minimally invasive surgery, or open surgery.
Some techniques done by colorectal surgeons include:
- Colonoscopy – Examination of the digestive system (colon lining and rectum) to detect irregularities in the bowel and determine possible symptoms of colorectal cancer.
- Sigmoidoscopy – Diagnostic test for examining the sigmoid colon (lower part of the large intestine or colon), which is close to the anus and rectum. This may be done to get a tissue sample (biopsy) and diagnose symptoms such as diarrhoea, constipation, polyps, bleeding, abdominal pain, etc.
- Laparoscopic surgery – A minimally invasive surgery allowing a doctor to make small, 0.5 to 1.0 cm cuts on the patient to treat conditions that may develop inside the abdomen or pelvis.
- Gastroscopy– Non-surgical procedure to examine a person’s upper digestive system.
Aside from advanced surgery techniques, a colorectal surgeon can also perform different procedures, including:
- Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) – Removal of difficult tumours.
- Polypectomy – Surgical removal of polyps from the intestines.
- Bowel resection surgery – Removing the entire large bowel or parts of it. This surgery is also known as a colectomy.
- Ostomy surgery – An operation that redirects bowel contents to a stoma or an opening outside the abdomen connecting to the digestive system.
- Appendicectomy – Removal of an infected or inflamed abdomen.
- Anastomosis surgery – Reversal of an ostomy. This procedure reconnects the colon to the remainder of the rectum after most of it has been removed through colorectal cancer surgery.
- Rectopexy – Repair of rectal prolapse. It can be performed through an abdominal incision or keyhole surgery.
- Lateral internal sphincterotomy – Operation to treat an anal fissure or a tear in the anal opening which can cause itching, pain, and bleeding.
- Hernia repair – Surgical procedure for fixing a hernia (herniorrhaphy).
- Open and stapler haemorrhoidectomy – Excision of excess haemorrhoid tissue by lifting and returning it to its original position.
Conclusion On What Colorectal Surgeons Do
The domain of a colorectal surgeon lies in treating, diagnosing, and conducting surgery on medical conditions affecting the lower GI tract.
Although not all colorectal conditions need surgical treatment, visiting a colorectal specialist is advised, as they can treat your condition more effectively.
Dr Q.M. Leong is a colorectal surgeon in Singapore with decades of experience in his field. He specialises in treating haemorrhoids, gallbladder diseases, peptic ulcer, diverticular disease, and other GI diseases.
Mount Alvernia Hospital
Medical Centre A
820 Thomson Road #01-06
Monday to Friday, 8:30am – 12:30pm, 2pm – 5:00 pm
Saturday: 8:30am – 12:00pm
Sunday and Public Holidays: Closed
Frequently Asked Questions About
What Colorectal Surgeons Do
There are different instances where a general surgeon may refer you to a colorectal doctor. For example, you’ll need to visit a surgeon if they discover a large polyp in your stomach which can’t be removed through an endoscopy. The doctor may also refer you to a colorectal surgeon for a colon cancer diagnosis.
Colorectal surgeons can treat benign and malignant conditions and perform routine colon screening and surgery when needed. Meanwhile, a gastroenterologist is a doctor who has completed internal medicine training and gastroenterology.
It is possible to feel painful sensations that come and go away a few days after undergoing colorectal or bowel surgery. You may experience the following:
- Bowel cramps
- Tenderness due to incision
- Flu-like symptoms
- Low-grade fever
Depending on the procedures and techniques, many patients need to recover for several days in the hospital after colorectal surgery. They may need 3-6 weeks of recovery at home.
Yes. Contact a colorectal surgeon in Singapore if you experience irritable bowel syndrome symptoms such as:
- Stomach cramps
- Frequent need for bowel movement
- Flatulence (excessive farting)