Should I See a Gastroenterologist or Proctologist for Hemorrhoids?

Reviewed on 2/26/2021
Hemorrhoids, commonly called piles, are swollen, inflamed veins around the anus
Hemorrhoids, commonly called piles, are swollen, inflamed veins around the anus

Hemorrhoids, commonly called piles, are swollen, inflamed veins around the anus or the lower part of the rectum (the terminal part of the large bowel). They may be felt as tiny lumps in and around the anus. Hemorrhoids may often get better on their own within a few days, but some may need medications and even surgery to go away.

Both gastroenterologists and proctologists can provide you treatment for hemorrhoids. Whether you should visit a gastroenterologist or proctologist depends on the type and severity of hemorrhoids you have. Hemorrhoids are of two main types:

  • External hemorrhoids: They form under the skin around the anus.
  • Internal hemorrhoids: They form in the lining of the anus and lower rectum.

Talk to a general physician to understand which doctor you need for hemorrhoid management.

A gastroenterologist is a doctor trained in the branch of internal medicine that focuses on the disorders of the gut, gallbladder, liver, bile ducts, and pancreas. A gastroenterologist can diagnose hemorrhoids, provide medications, and advise lifestyle modifications. They can also do certain procedures, such as endoscopy (insertion of a flexible tube with a camera into the gut) and hemorrhoid banding (the doctor places a special rubber band around the base of hemorrhoid to cut off the blood supply).

A proctologist or colorectal surgeon, however, is a specialist medical doctor trained in the branch of medicine dealing with the structure and diseases of the anus, rectum, and sigmoid colon (proctology). Thus, a proctologist can diagnose and treat hemorrhoids. Unlike the gastroenterologist, a proctologist can also provide surgical treatment for hemorrhoids. If you have severe hemorrhoids, the proctologist may advise a hemorrhoidectomy, which is a surgical procedure to remove large external hemorrhoids and prolapsing internal hemorrhoids (hemorrhoids that bulge out of the anus). Alternatively, they may perform hemorrhoid stapling in which the surgeon uses a special stapling tool to remove internal hemorrhoids and pull a prolapsing internal hemorrhoid back into the anus.

What training does a proctologist have?

To become a proctologist, you must first become a general surgeon. This includes 5 years of surgical residency after medical school. During their training, the general surgeons learn to perform different types of surgeries, such as hernia surgery, hemorrhoidal surgery, gallbladder surgery, breast surgery, and even vascular surgery. Thereafter, they do an extra year of specialized surgical training in surgeries on the colon, rectum, and anus to practice as a proctologist.

When should you visit a doctor for hemorrhoid treatment?

Hemorrhoids may be managed by lifestyle modifications, such as drinking plenty of fluids, having a healthy diet rich in fruits and vegetables, and maintaining a healthy weight. This is especially true in the case of small and uncomplicated hemorrhoids in people with good general health. Sitz baths with warm water and potassium permanganate will also help. If you have the following symptoms you must take the doctor’s help right away:

  • Hard, tender lumps felt at the bottom (anus)
  • Anal pain, especially while sitting
  • Bleeding from the rectum observed as bright red blood in the stool, on toilet paper, or in the toilet bowl after a bowel movement
  • A bulging or swelling may be felt through the anus in case of a prolapsed hemorrhoid (hemorrhoid that has bulged or fallen through the anal opening)
  • You have tried over the counter medications for more than a week, but there is no relief of symptoms

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References
Maine Health. Proctology. https://www.mainehealth.org/Services/Gastroenterology/Proctology#:~:text=Proctologists%20are%20different%20than%20gastroenterologists,specialty%20area%20of%20the%20proctologist

Geisinger Health. When to See Your Doctor About Your Hemorrhoids. February 2, 2021. https://www.geisinger.org/health-and-wellness/wellness-articles/2017/03/23/16/13/when-to-see-your-doctor-about-your-hemmorrhoids

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