Proctologist vs Colorectal Surgeon: You’ve heard both terms, but what’s the difference between them and do they treat the same conditions?

A common question patients ask me is, what is the difference between a proctologist and a colorectal surgeon? Many people have not even heard of the term colorectal surgeon, or believe it to be a different specialty than proctology. However, the disambiguation is very simple. A proctologist is a colorectal surgeon and vice versa. A colorectal surgeon is the formal term for a proctologist. The two terms technically refer to the same specialized doctor, but they often end up representing slightly different subspecialties within the colorectal niche.

History of the Terms Proctologist and Colorectal Surgeon

History of the Terms Proctologist and Colorectal Surgeon

Back in 1835, the field of proctology was becoming a specialty, focusing on diseases of the colon, rectum, and anus. Doctors at the time did not have an interest in treating such diseases, so patients would go outside of the traditional medical field to “quacks and charlatans” to get help. 

Due to the mistreatment of these duped patients, a group of doctors felt a specialty was needed so patients could get the help they needed from medical professionals. This gap in the market formed the field of proctology, with such doctors being referred to as proctologists.

The reason for the emergence of the term colorectal surgeon is due to the term proctologist being confusing in nature. Procto comes from the Greek proktos, which means anus. The issue with this specificity is that the anus is just the opening at the end of the alimentary canal, but nothing more. This gave the false indication that a proctologist was simply an anal specialist or “butt” doctor – a misunderstanding that remains an issue to this day. However, proctologists and colorectal surgeons both treat a much wider range of diseases of the colon and rectum, as well as the small bowel – not just the anus. 

To minimize confusion and clarify that a proctologist is not simply a “butt” doctor, the proper name changed to colon and rectal surgeon, or colorectal surgeon for short, more accurately representing the breadth of the diseases treated. However, as the general public knew a proctologist treated hemorrhoids and “butt” issues, it now became difficult to find this specialist as the name changed to colon and rectal surgeon. A colon and rectal surgeon, by the name, seems like they don’t treat anal conditions like hemorrhoids, though they do. 

Proctologists and Colorectal Surgeons Today

Proctologists and Colorectal Surgeons Today

All surgeons who train to become colon and rectal surgeons must complete a 5 year general surgery training and complete the surgery boards. The next step is to apply and get accepted into an accredited fellowship for colon and rectal surgery.  After this one year specialized training the surgeon must pass the boards for colon and rectal surgery. Colon and rectal surgeons are double board certified in colon and rectal surgery and general surgery.  Most choose only to perform the specialty of colon and rectal surgery.

The majority of colon and rectal surgeons don’t like to be called proctologists because, as explained in the previous section, they feel being called a proctologist means they only treat “butt” issues like hemorrhoids, anal itching, anal fistulas along with performing colonoscopies. As colorectal surgeons operate on a vast array of colon and rectal issues they don’t want to be labeled a “butt” doctor.

Despite being qualified to do so, I (Dr. David Rosenfeld) personally gave up performing surgery of the colon and rectum. I work on the anus and distal rectum along with performing colonoscopies. For this reason I label myself as a “pure proctologist” as the majority of individuals searching for a proctologist are looking for a “butt” doctor and more directly related “butt” needs. In the event that a patient has needs outside of my specialty, I simply refer them to a colon and rectal surgeon.

What conditions do colon and rectal surgeons treat?

Proctologists / colorectal surgeons treat many conditions of the large intestinal tract.The large intestinal track includes the colon, rectum, anal canal, and perianal area. These conditions include:

  • Hemorrhoids – Swollen veins that can occur internally and externally around the anus
  • Fissures – Small tears in the anal lining
  • Fistula-in-ano – infected tunnel between the skin and anus
  • Anal itching
  • Irritable bowel syndrome with constipation or mushy, loose stool.
  • Pilonidal Cysts – abnormal skin growth located at the tailbone that contains hair and skin
  • Fissure-in-ano – small tear in the lining of the anus
  • Colon and Rectal Cancer – cancers of the colon and rectal regions
  •  Anal Cancer – typically the diagnosis of the mass.  Surgery is usually not needed as chemoradiation therapy works very well to cure anal cancer.
  • Rectal Prolapse – a condition when the rectum slips out through the anal opening
  • Crohn’s and Ulcerative Colitis
  • Condyloma (warts)
  • Diverticulitis
  • Genital herpes
  • Colon polyps – Colonoscopy with polypectomy
  • Anal or perirectal abscess
  • Condyloma (warts)
  • HIV and AIDS associated anorectal diseases

When to See a Proctologist

When to See a Proctologist

The vast majority of people find a proctologist online as most patients are too embarrassed to tell anyone – even their primary care provider – about issues they are having with the anus. Below are reasons to seek out the help of a specialist.

  • Anal itching or burning
  • Bleeding or other discharge from the anus
  • Rectal pain
  • Anal warts 
  • Anal lumps or bumps
  • Sharp pain and bleeding with a bowel movement
  • Painful lump on the rump.
  • Change in bowel habits
  • Screening for a colonoscopy (Starts at age 45 or younger if any bleeding, family history of polyps or colorectal cancer)
  • Any other changes to your anus and rectal area that are concerning. Your primary care doctor can recommend if you need one

How to Find a Proctologist

If you have concerns about changes in your system, contact your primary care doctor who can give recommendations, or go online and search for a proctologist.  A good source of proctologists and colorectal surgeons is the ASCRS website.  Here at T.O.P – Thousand Oaks Proctology, office of Dr. David Rosenfeld, we are at the TOP of our game to get to the BOTTOM of your problems.  We have the experience to help ease your worries and educate you about different conditions. We offer compassionate care with a gentle touch of butt humor. Contact us to request an appointment.