What proctologic procedures are offered in the clinic?
Proctologic conditions affecting the anus and rectum are very common. Many patients with proctologic conditions are treated with medications without the need for surgery. In some patients, a procedure is necessary to further investigate or treat the patient’s symptoms. Some of the proctologic procedures are performed in the clinic. Dr. Maher Abbas provides state of the art proctologic care and offers these procedures:
- Diagnostic procedures. These procedures are helpful to further investigate the patient’s symptoms:
- Anoscopy. During this exam a small instrument inspects the inside of the anus
- Anorectal manometry. Patients with pelvic floor dysfunction including those with constipation, straining, inability to empty, or stool incontinence are investigated with anorectal manometry. A soft tube is inserted inside the anus and rectum and various pressure recordings are collected to test the function of the anus and rectum
- Skin biopsy of lesions inside or around the anal skin is done and submitted for further evaluation
- Proctoscopy and Sigmoidoscopy. The rectum and sigmoid colon are inspected with proctoscopy and sigmoidoscopy. These tests are helpful in patients with rectal bleeding, inflammation, infection, or tumors. In some patients, sigmoidoscopy is performed in the endoscopy suite under intravenous sedation
- Treatment procedures. The following interventions are performed to help alleviate the symptoms of proctologic disorders:
- Anal dilation. Patients with narrowing of the anal opening due to stricture (scarring) or muscle spasm benefit from anal dilation to stretch the anus
- Botox® Patients with anal spasm or fissure can benefit from Botox® injection to relax the anal sphincter muscle
- Infrared coagulation. Infrared coagulation [Figure 1] delivers heat energy to the area above and surrounding the internal hemorrhoids. This causes scarring and shrinkage of the hemorrhoids. While many commercial clinics refer to infrared coagulation as “laser” for marketing purposes, it is not a laser intervention. Most patients require more than 1 treatment session
Figure 1 – Infrared coagulation for internal hemorrhoids
- Rubber band ligation. Rubber band ligation shrinks the hemorrhoid by applying a rubber band along the upper aspect of an internal hemorrhoid. Most patients can require more than 1 treatment sessions to treat multiple hemorrhoids
Figure 2 – Rubber band ligation of internal hemorrhoids
- Treatment of anal warts. Anal Warts are growth related to infection by the human papilloma virus (HPV). Patients with a limited number of warts can be treated in the office by liquid nitrogen application, fulguration, or excision
- Skin tag excision. Skin tags around the anal opening are common. Most tags can be left alone but if they cause symptoms they can be removed in the office.
How are these procedures performed?
Clinic based procedures are done with the patient awake. A local anesthetic is used for some procedures. Patients can resume work the same day or the following day depending on the type of the procedure. Dr. Maher Abbas will provide you with all instructions at the time of the visit.
Why seek expert care with a board certified proctologist and colorectal surgeon?
The anal area is a delicate part of the body. It is important to seek care to heal, relieve symptoms, and to exclude other more serious causes of anal symptoms. The expertise of the doctor is critical in order to ensure the best result and minimize the risk of recurrence, non-healing, infection, and developing any weakness in the anal muscle. Proctology is a highly specialized field.
Dr. Maher Abbas is an expert in the treatment of diseases of the colon, rectum, and anus. With over a 30-year career in the USA, he has completed advanced training in Proctology and is American Board Certified in Colon and Rectal Surgery. Dr. Maher Abbas is a Fellow of the American Society of Colon and Rectal Surgeons.
If you would like to schedule a consultation with Dr. Maher Abbas to discuss your case, click here.