Proctologist in Latviawhen to go, how to prepare, what treatments exist

A proctologist, or colorectal surgery specialist, diagnoses and treats disease of the colon, rectum and perineum.

• Haemorrhoids
• Anal fissures
• Fistulas
• Polyps
• Rectal prolapse
• Diverticulitis
• Inflammatory bowel disease
• Colorectal cancer

Veselības centrs 4 states that around 50 per cent of the population experiences haemorrhoids at some point, and that roughly one third of patients attending a proctologist are diagnosed with haemorrhoidal disease.

For women, the number of births matters. Veselības centrs 4 states that women who have had three children face up to an 80 per cent probability of developing functional perineal conditions.

The ARS medical centre states that bleeding, pain and other symptoms may indicate either benign bowel disease or colorectal cancer, and that if these symptoms are accompanied by persistent fatigue or weight loss, you should see a doctor without delay.

For prevention, a proctology visit is worth considering after age 45, particularly for people with a family history of colorectal cancer.

Separately, the state bowel cancer screening programme with a faecal occult blood test covers ages 50 to 74.

GASTRO centrs gives specific preparation instructions:

• Intimate hygiene before the visit is advisable.
• One hour before the appointment, prepare using a single Microlax enema.

Veselības centrs 4 adds:

• Before going, think about whether the sensations appeared in recent months.
• Write your questions down beforehand, since a proctology visit makes some people tense and they forget much of what they meant to ask.

Delay is this field's biggest problem. Because these conditions affect the most intimate part of the body, appointments are often postponed until the condition has worsened.

Veselības centrs 4 states that first and second stage haemorrhoids are treated conservatively, while surgical methods are used from the third stage onwards.

• Tests on site. If colonoscopy is likely, choose a provider that performs it, including under anaesthesia.
• Method. Modern methods such as THD and RAFAELO allow a faster return to normal life but are usually private.
• Stage. Early stages may need only conservative treatment, so an early visit can avoid surgery.
• Multiple visits. Reaching a full diagnosis can take two or three visits, so choose somewhere convenient.
• Insurance. Some providers accept insurance-funded services.

• The doctor takes a history covering symptoms, bowel habits, diet and lifestyle, and for women also pregnancies and births.
• An examination follows, with anoscopy, rectoscopy or colonoscopy as needed.
• If that does not reveal the problem, further tests may follow, including barium enema, fibrocolonoscopy, colonic transit time assessment, defecography and ultrasound of the rectum and perineum, plus a consultation with another specialist such as a gastroenterologist.
• Veselības centrs 4 states that reaching a full diagnosis will require at least two or three proctology visits.
• Follow-up and repeat visits are arranged after procedures.

In the public system, with a referral, a specialist visit costs 4.00 EUR, an endoscopy 7.00 EUR, and an operation in a day hospital 4.00 EUR. Several modern haemorrhoid treatments are private.

• Patient co-payment for a specialist visitPrice EUR: 4.00Source: NVD
• Patient co-payment for an endoscopic examinationPrice EUR: 7.00Source: NVD
• Operation as outpatient or in day hospitalPrice EUR: 4.00Source: NVD
• Bowel cancer screening by faecal occult blood test, ages 50 to 74Price EUR: 0.00Source: GASTRO centrs
• RAFAELO, THD and other modern methodsPrice EUR: per clinic price listSource: Juglas klīnika, ARS

The specialty body is the association "Latvijas koloproktologu biedrība" (Latvian Society of Coloproctologists), registration number 40008235290, registered address Marijas iela 23-6, Rīga, LV-1011, contact Ints Bruņenieks, email koloproktologubiedriba@gmail.com.

Certificates are issued by the Certification Council of the Latvian Medical Association. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of care, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.