I think it is extremely important to ask the patient thoroughly about the symptoms, their nature and duration at the beginning of the proctological examination, as without this a wrong diagnosis could be made."

In this article, Dr. Diána Mocsári, Dr. Rose Private Hospital’s proctologist, summarizes the most common diseases and informs us about the examination.

Diseases of the rectum can be benign or malignant. Benign lesions include: hemorrhoids, fissures, blood clots, rectal skin lesions, fistulas, abscesses, inflamed caruncles (fleshy outgrowth), dysfunction of the pelvic floor muscles, rectal lesions caused by various STIs (sexually transmitted infections) and rectal manifestations of IBDs (inflammatory bowel diseases).

As the location is intimate, it is understandable that patients often consult a doctor only after a long period of hesitation. It is important to note here that a proctological examination involves minimal discomfort and does not require any intestinal preparation.

In fact, the last 20cm of the rectum is usually empty under normal metabolism. I therefore think it is important to consult a specialist as soon as possible when symptoms appear, because research and self-diagnosis on the Internet can often lead us in the wrong direction, and neglecting diseases can cause complications and discomfort, not to mention the anxiety caused by fear and uncertainty.

The examination is carried out in the left lateral recumbent position with the legs pulled up towards the abdomen, starting with a view of the rectal area. This is followed by a digital rectal examination (called DRE), during which the internal sphincter is palpated internally with the index finger to check the tone and function of the sphincter and the condition of the pelvic floor muscles.

This is followed by an examination with an anoscope, which allows us to view the inside of the anal canal up to 11-12cm. The patient is then informed in detail about the results of the examination and the therapeutic options. In this way we can tailor a therapy to the individual patient based on the examination.

The symptoms of rectal diseases can be very varied. Abscesses usually cause a sharp, stabbing pain at the moment of defecation, accompanied by fresh bleeding as seen on the toilet paper. In the early stages, hemorrhoids usually produce fresh droplets of blood without causing pain.

The burning, stinging discomfort, which occurs hours after defecation and often lasts all day, may be caused by spasm of the internal sphincter, possibly due to tightening of the pelvic floor muscles. Sudden lumps in the rectal area, which cause a tightening pain and can be felt by the patient, may be blood clots, prolapsed hemorrhoids or abscesses. Bloody mucus in stools may be caused by contagious sexually transmitted infections, inflammatory bowel diseases, or polyps higher up in the intestinal tract.

It is therefore of the utmost importance that our patients come to us as soon as possible with confidence and without fear in the event of rectal complaints. We will then question them thoroughly, compare this information with what we see during the physical examination, then establish a correct diagnosis and draw up a personalized treatment plan.

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