Proctology: 17 questions that people are embarrassed to ask a doctor

Taking care of your health is not just a normal approach to life, but also a duty to yourself. Due to traditions and not quite the right upbringing, people do not always feel comfortable visiting doctors of certain specialties.

Intent continues its series of partner publications on health. Anastasiia Kharitonova, an endoscopist and proctologist at Odrex Medical House in Odesa, answered the questions that patients are embarrassed to ask during consultations.

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1. What should a normal stool look like?

General surgeons and proctologists use the Bristol scale, which has seven types of stool shape and consistency. The third and fourth types are normal. The third type is a sausage with a ribbed surface, the fourth is a sausage with a smooth surface. If there are any deviations, you should consult a doctor.

2. Why does feces have an unpleasant odor?

Unpleasant odor is associated with digestive disorders. If a person feels some kind of purulent odor or is simply uncomfortable, it is better to consult a gastroenterologist.

3. Why does it sometimes feel like the intestines are not completely empty?

There are many reasons for this. Here are just a few of them:

• Rectocele (protrusion of the rectovaginal membrane) - a pocket is formed where feces gets stuck. It hardens there, and then there is a feeling that you need to go to the toilet again. This is the same feeling of an incompletely emptied bowel;
• presence of benign or malignant tumors.
• various proctitis is an inflammation of the rectal mucosa.
• Very often it is an irritable bowel syndrome.

Therefore, if you feel that you have not gone to the toilet completely, that you need to go again, then it is better to seek advice.

4. How many times a day or a week should I go to the toilet?

If you have been going once every three days since childhood, this is absolutely normal. If you used to go once a day and then started going once every three days, then this is constipation. In general, according to American protocols, defecating once a week is not considered constipation, but for us it is a lot.

5. Should I strain in the toilet?

You should not strain in the toilet. It is better to sit in a normal physiological position for defecation. People say that this is the eagle's pose. For convenience, you can put a stand or a small bench so that your knees are higher than your buttocks.

6. What kind of toilet paper should be used?

It is better not to use toilet paper. A cool shower that goes up is best. If there are no conditions to wash yourself after the toilet, it is better to use wet toilet paper.

7. Is it necessary to use soap for anus hygiene?

You do not need to use soap, just running, cool water. This is important because soap disrupts the microflora of the perianal area. Soap should be used only as prescribed by a doctor if you have, for example, dermatitis or skin lesions. Intimate hygiene gel is also a soap product, so we do not use it in this area.

8. What should I do if there are traces on the underwear after defecation?

There are many reasons for this. There are proctologic reasons (hemorrhoids, anal fissures, anal fringes, condition after regular anal sex) and hygienic reasons (lack of a hygienic shower after defecation or excessive anal hairiness). The latter can be dealt with on your own. Wash well and use cosmetic procedures, for example, a laser to remove hair.

9. Why do I sometimes experience uncontrolled gas discharge?

This indicates problems with the sphincter. Most often, the issue of uncontrolled gas or feces concerns people who regularly have anal sex. The anus exists to defecate and remove feces from the intestines. If the anus is not used for its intended purpose, such problems occur. Symptoms can also occur in people with diagnosed cancer, it can be a tumor that grows into the sphincter fibers.

10. What to do if you have fecal incontinence?

In addition to the reasons we have discussed, it can be a birth injury to the central nervous system, Hirschsprung's disease, connective and muscle tissue disease, or tumor processes in the rectum or sphincter. What can we do and how can we solve it? It can be controlled by adjusting the hygiene of the anal area, exercising and regular check-ups with a doctor.

11. Why do I need to visit a proctologist? Is it necessary to visit a proctologist at all if there are no complaints?

You should definitely have a screening once a year. But if you are concerned about something, namely mucus after defecation, itching, pain in the anal canal, or if it so happens that a toy is left there, then immediately contact a proctologist.

12. Is it necessary to conduct a physical examination (the one done with a finger) or is there an alternative?

It is necessary to conduct an examination with a finger and in mirrors, because without this, the diagnosis will be inaccurate, it will just be a joke on the part of the doctor. Is there an alternative? Yes - the gentle female hands of a proctologist.

13. Is it possible to cure hemorrhoids without surgery?

There are four stages of hemorrhoids. The first two can be controlled with medication. But even if you operate on the third or fourth stage, you will need to change your lifestyle. If you don't change your habits, this is the way to be a regular client of a proctologist.

14. What are anal fissures, where can they come from?

Anal fissures are a defect in the mucous membrane of the anal area that occurs after constipation, hard stools or the presence of solid fractions in the stool, diarrhea or anal sex. Can they heal on their own? Yes, there is a concept of an acute fissure or a chronic fissure. An acute fissure can heal on its own if, for example, constipation has occurred once.

15. Why are proctologists against anal sex?

Let's not be so categorical about this, but there are several problems that arise after anal sex. The first is damage to the mucous membrane of the anal canal and rectum. Its solution is the consent of both parties, sustained foreplay and the use of the right lubricant. The second problem is gas and fecal incontinence. The solution is, firstly, to change the frequency of acts, and secondly, to do everything according to the rules. The third problem is specific proctitis, which most often occurs due to sexually transmitted diseases. The solution is to use a condom and water-based lubricants, even if you have been married for many years. Mucus, saliva, petroleum jelly, or shark liver oil are not suitable - only lubricant.

16. The procedure of anus whitening is now popular in cosmetology. Is it safe?

I hoped that this question would not concern me, but our asshole was invented for only one thing: the removal of feces from the rectum. Everything there is designed to protect our microflora from the influence of feces - there are 62 million bacteria in it.

If you go to that delicate area with peeling or a laser (I'm not talking about a laser used for hair removal, but for bleaching), it will be primarily an injury. How do you go to the restroom afterwards? You should always wash your face and use proper hygiene. Failure to comply with these requirements can lead to paraproctitis, abscesses, and dermatitis.

Love yourself, love your asshole, because that's how nature designed it. I really hope that no one has friends or partners who say: "Oh my God, you have a dark anus, that's really bad".

17. Why did you choose proctology?

After some situations when I was still an intern in general surgery, many patients came to me for proctology care. I realized that it is really easier for many people - no matter if they are women or men - to open up and trust a female proctologist. Then I realized that I would be useful in this area and decided to become a proctologist during my second year of internship.

Ігор Льов