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This is how a proctological examination works



  • What is proctology about?
  • What are problems treated in proctology practice?
  • How does a proctological examination work?
  • What exactly are hemorrhoids?
  • Colonoscopy: How does it work and when is it necessary?
  • How do I get rid of the shame before a proctological examination?
  • Tips for a healthy anal region
  • The pelvic floor is also a case for proctology

Proctology doesn’t exactly provide conversation material for a cozy atmosphere at the café table or for a romantic dinner. Most people find proctological topics unpleasant, and for many they even trigger feelings of shame. Proctologist Dr. med. univ. Florian Frank, who works as a senior physician at the Munich Clinic Neuperlach. With his book After Hour. During your consultation with the proctologist, he will approach topics such as constipation, hemorrhoids or anal fissures with humor and lower your inhibitions.

We are pursuing exactly the same purpose with this article and have therefore sought help from Florian Frank. Quick treatment of proctological complaints is very important because they can become quite unpleasant. “As a rule, people with proctological complaints are confronted with this on a daily basis because the intestines are constantly in action. The anus area is characterized by a particularly high density of nerves, so that even relatively mild complaints can have a greater impact,” says the proctologist. That’s another reason why it’s worth forgetting about shame as quickly as possible.

What is proctology about?

“With the region where no sun shines,” Florian Frank summarizes his area of ​​operation. A little more scientific: It’s about the health and diseases of the anal region, i.e. the anus and rectum. Prōktós comes from Greek and means anus, rump or anus.

And to clear up a widespread misunderstanding: Proctological examinations are not only carried out on men, but on men and women equally. “Almost all people are plagued by proctological problems in the course of their lives. Whether due to the widespread disease hemorrhoids, during pregnancy or childbirth or as a result of sexual acts,” says the proctologist.

A huge problem that he knows from his everyday practice: For most people, the anal region is a source of shame, or they imagine the corresponding examinations to be unpleasant or painful, so that many only seek medical help when the symptoms are almost unbearable.

What are problems treated in proctology practice?

The diversity is impressive. Possible complaints or problems that are best dealt with in a proctology practice include:

  • Blood in the stool or other noticeable changes
  • Hemorrhoids or problems with it
  • itching
  • Injuries to the anal region (for example through accidents during sex or masturbation)
  • STDs
  • Anal fissuresi.e. cracks in the anal mucosa
  • Analabszesse or fistulas
  • Colon cancer is the second most common type of cancer in both men (after prostate cancer) and women (after breast cancer). Although there has been a significant decline in mortality for years, studies have shown that this is primarily due to improved prevention. In other words: Only those who go to the doctor can help to further reduce these statistics.
  • Urinary incontinence Affects about 10 percent of men and 15 percent of women, according to a 2005 study, and its frequency increases with age.

How does a proctological examination work?

For many people, the most difficult step of a proctological examination is probably the effort to make an appointment. During the consultation, the symptoms are discussed and, depending on the case and problem, a physical examination is carried out, during which the area is inspected, palpated and, if necessary, looked at with an examination device.

To ensure that there is as little stool as possible in the rectum during the examination, patients are given a small enema beforehand. Palpation without or with appropriate devices is usually painless. “The devices are no thicker than a finger and therefore significantly thinner than stool – and in the best case scenario this happens without pain,” reassures the proctologist. Depending on the symptoms, further examinations may follow, such as ultrasound or X-ray examinations or a colonoscopy. For some illnesses, a surgical procedure is unavoidable – but it can provide quick relief. For other complaints, ointments, preparations or a change in diet can help.

What exactly are hemorrhoids?

According to Dr. Frankly, around 70 percent of all people suffer from hemorrhoids at some point in their lives. “The number of unreported cases is most likely even higher because not all sufferers dare to go to a proctologist,” he suspects. Hemorrhoids themselves are not a bad thing – on the contrary, we all have them. These are wide blood vessels that lie like a cushion in the upper anal canal and ensure a secure seal of the rectum. “Hemorrhoids are actually heroes – as long as they don’t cause any problems,” says Dr. Frank.

Problems are usually not characterized by acute pain, but by bleeding, a bulge in the anus or itching. In Germany, around 3.3 million people are treated for hemorrhoid problems every year – only 1.5 percent of them require surgery.

Colonoscopy: How does it work and when is it necessary?

For a colonoscopy or colonoscopy, the entire intestine must be emptied before the procedure so that the inside can be viewed as best as possible. To do this, a laxative solution is drunk the day before. The examination can be carried out in twilight sleep or without anesthesia.

Colonoscopy is particularly important as part of cancer prevention: this is the only way to detect growths in the mucous membrane and, if necessary, remove them. “In the case of colon cancer, there is a special constellation in that, on the one hand, it is relatively common. On the other hand, the chances of treatment are excellent if it is diagnosed in a timely manner,” says Dr. Frank. This makes regular cancer screening all the more important.

How do I get rid of the shame before a proctological examination?

Proctologist Frank estimates that a proctologist sees an average of 4,000 buttocks per year: “Whatever you present in the examination chair will most likely not surprise any proctologist.”

He also reports that patients feel extremely relieved after successful treatment and therefore expressly advocates getting rid of shame and treating the anus region no differently than other parts of the body.

Tips for a healthy anal region

Many proctological problems can be avoided with the right care and some basic knowledge. Proctologist Florian Frank has these tips, among others:

  • Big business: There are a few tips to ensure that going to the toilet goes smoothly. The “session” should not last too long so that pathologically enlarged hemorrhoids do not form. For the same reason, you shouldn’t press too hard. Elevating the legs, the so-called “Stone Age squat” at a 35 degree angle, can make bowel movements easier. There are very helpful stools you can buy, for example this one.
  • Cleaning: Because toilet paper can irritate the sensitive skin of the anal region, it is better to clean yourself with lukewarm water. This works with a bidet, the shower head or, in brilliant comfort, with a mobile bidet, i.e. a small handheld shower that you can take with you. The expert advises against using damp toilet paper, as it often contains irritating ingredients.
  • Good nutrition: Adequate intake of fiber ensures healthy bowel movements, which ensures more volume and suppleness of the stool. According to the German Nutrition Society, adults should consume at least 30 g of fiber per day, for example in whole grain products, legumes or fruit such as apples or pears. Sufficient fluid is also important so that it flows better.
  • Movement: Enough exercise can alleviate or prevent proctological problems. A sluggish lifestyle also makes the intestines sluggish and can lead to digestive difficulties or constipation.
  • Anal Sex: Because the anus has a high density of nerve endings and is in close proximity to other erogenous zones such as the G-spot or prostate, many people find it pleasant when it is massaged or penetrated. Plenty of lubricant is important. Fingers and sex toys are suitable for this – objects like vegetables, bottles or candles are not (there are enough books and texts by doctors who had to remove strange objects from human buttocks). And of course also important: contraception. Using condoms significantly reduces the risk of contracting sexually transmitted diseases.

The pelvic floor is also a case for proctology

The pelvic floor is particularly important when it comes to stool and urinary continence. In women, changes in the pelvic floor region can occur during pregnancy and after birth, which is why postnatal courses and pelvic floor training are strongly recommended. But men shouldn’t forget about their pelvic floor area either, says the proctologist: “Especially in the second half of life, men can improve both their urinary continence and their erectile function through regular pelvic floor training.”

Shame or fear of a proctological examination is normal, but not at all appropriate. A visit there can help you get rid of unpleasant problems and even prolong your life. If you have any complaints, clarify them, just as you would have a toothache or a sprained ankle treated immediately.


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