Our proctologist diagnoses and treats diseases of the anus, rectum, and colon, such as haemorrhoids, anal fissures, and rectal fistulas. In cases of detected rectal or colon tumours, we refer patients for treatment according to established clinical guidelines.

The initial consultation begins with a detailed discussion, during which we review your symptoms and medical history. This is followed by a clinical examination performed in a left lateral position with the knees drawn towards the abdomen. The doctor examines the perianal area and performs an anoscopy. The entire procedure is quick and performed with sensitivity and care.

Important information:

• Preparation is required. 1–2 hours before the appointment, you must use a Microlax micro-enema, which takes effect within approximately 15 minutes. Remove the cap from the applicator tip, gently squeeze until a small amount of liquid appears, insert the tip fully into the rectum, empty the tube, and then carefully withdraw the applicator while keeping it compressed.
• For the anoscopy examination, a pain-relieving gel is used.

Anoscopy is a simple and quick examination in which the doctor evaluates the anus and the lower part of the rectum using a special disposable instrument called an anoscope. The examination is performed in a left lateral position with the knees drawn towards the abdomen.

When is anoscopy needed?

Anoscopy is used to detect and assess conditions such as haemorrhoids, anal fissures, inflammation, or other abnormalities.

Important information

• The examination is usually performed during the consultation visit.
• Bowel preparation is required using a Microlax micro-enema approximately 2 hours before the appointment.
• The procedure is quick and lasts only a few minutes.
• A pain-relieving gel is used during the examination.

In the case of an external haemorrhoid thrombosis, a firm, purple, and painful lump forms in the anal area. In some cases, the thrombosis may resolve with conservative treatment using painkillers or topical creams.

When does a haemorrhoid thrombosis need to be opened?

The procedure is indicated in the following cases:

• severe, throbbing pain in the thrombosed haemorrhoid;
• a large and tense thrombosed external haemorrhoid;
• symptoms present for less than 72 hours;
• conservative treatment (e.g. ointments or pain relief medication) has not been effective.

This is a minimally invasive procedure that does not require general anesthesia or hospitalisation. A small rubber band is placed around an internal haemorrhoid, cutting off its blood supply. As a result, the haemorrhoid shrinks and typically falls off within 7–10 days.

Who is this treatment suitable for?

• Grade II–III internal haemorrhoids
• Bleeding, discomfort, or prolapsing internal haemorrhoids
• Cases where conservative treatment has not been effective

Important information

• Ligation is not suitable for the treatment of external haemorrhoids.
• Bowel preparation is required using a Microlax micro-enema 2 hours before the procedure.
• f you are taking blood-thinning medication, a prior consultation is required to assess suitability and safety of the procedure.

Hemorrhoid sclerotherapy is a quick and painless treatment method that does not require surgical intervention. During the procedure, a sclerosing agent is injected under the mucosa near the internal haemorrhoid, causing the blood vessels to constrict and close. As a result, blood flow to the haemorrhoid decreases, the haemorrhoidal tissue shrinks, and the haemorrhoid gradually regresses.

When is sclerotherapy suitable?

The procedure is suitable if:

• there is no recurrent prolapse of the haemorrhoid;
• there is recurrent mild or moderate bleeding;
• symptoms persist or worsen despite medication;
• there is daily itching, discomfort, or a burning sensation;
• the condition is Grade I–III internal haemorrhoids.

Important information

• Bowel preparation is required using a Microlax micro-enema 2 hours before the procedure.
• The procedure is quick and takes only a few minutes.
• If necessary, the procedure can be repeated after 4–6 weeks.
• Sclerotherapy can be combined with laser treatment and rubber band ligation.

Treatment of anal fissure with botulinum toxin injection is one of the newer methods used for managing chronic anal fissures. Spasm of the anal sphincter reduces blood flow and impairs tissue healing, which can cause the fissure to become chronic.

The goal of the procedure is to temporarily block nerve impulses in the muscle using botulinum toxin. This helps reduce sphincter spasm, relax the anal muscle, improve blood circulation, and promote healing.

When is botulinum toxin treatment for anal fissure needed?

The procedure is indicated if:

• a chronic anal fissure has not healed after 6–8 weeks of treatment, with persistent pain and bleeding;
• it can be combined with surgical treatment if necessary.

After surgical treatment of haemorrhoids, anal wounds often heal with the formation of skin folds. Small residual skin tags around the anus may also develop after haemorrhoids, thrombosis, or inflammation have resolved. If these residual skin tags cause discomfort or are bothersome, they can be removed once at least 2–3 months have passed since the resolution of the haemorrhoidal condition.

Although skin tags are not dangerous, they may cause itching, irritation, as well as cosmetic and hygiene-related concerns.

When should you see a doctor?

• bothersome skin folds remain after haemorrhoid treatment;
• maintaining anal hygiene is difficult;
• you experience itching, irritation, or discharge;
• friction is felt during movement.

Important information

• The procedure is painless and performed under local anaesthesia.
• It is a quick procedure lasting 20–30 minutes.
• Wounds heal without sutures.
• Avoid alcohol and spicy foods for 2–3 days before the procedure.
• Use a Microlax micro-enema before the procedure.
• nform the doctor about all medications you are taking, especially blood thinners.

Laser treatment is an innovative procedure for the treatment of pilonidal sinus disease. The cyst tissue is treated using a minimally invasive laser device, requiring only a small incision.

A pilonidal sinus is a chronic inflammatory condition, often presenting as an abscess or infected cavity in the intergluteal cleft. The most common cause is ingrown hair (pilus = hair, nidus = nest). Hair penetrates under the skin, allowing bacteria to enter, leading to infection and pus formation that the body cannot eliminate on its own.

Forms of pilonidal sinus disease

• Mild form – barely visible externally, only small skin openings
• Acute abscess – redness, swelling, pain when sitting or walking; discharge of pus and blood
• Chronic form – no acute symptoms; skin openings with intermittent purulent or bloody discharge

Haemorrhoidectomy is a surgical procedure in which haemorrhoidal tissue is removed. The operation is performed when haemorrhoids cause severe pain, itching, bleeding, or no longer respond to other treatments (such as creams, suppositories, or minimally invasive procedures).

Haemorrhoidectomy is performed under general anaesthesia.

When is surgical removal of haemorrhoids needed?

Surgery is indicated if:

• previous treatment methods (e.g. ointments, rubber band ligation, or other minimally invasive procedures) have not been effective;
• the condition recurs after previous treatment;
• there are Grade IV internal haemorrhoids (prolapse during every bowel movement and do not reduce spontaneously);
• other treatment options are not possible or suitable;
• the haemorrhoidal tissue is large and the patient prefers a single definitive procedure.

Fissurectomy is a surgical procedure in which a painful anal fissure (a wound in the anal canal) is removed. The operation is performed when the fissure no longer heals on its own or with medication and continues to cause pain, bleeding, or inflammation.

The procedure is performed under general anaesthesia, and the edges of the wound are excised. If necessary, the procedure may be combined with a botulinum toxin injection or reconstruction (coverage of the defect with surrounding tissue) after removal of the fissure.

When is surgery for anal fissure necessary?

Fissurectomy is indicated if:

• the anal fissure does not heal with conservative treatment (ointments, dietary changes, stool regulation);
• there is persistent pain or bleeding;
• the fissure tends to recur;
• chronic inflammation or scar tissue develops, preventing healing.

What should you know before surgery?

• The operation is performed under general anaesthesia.
• Follow the preoperative instructions provided to you.

When is surgery necessary?

Polyps of the anal canal and lower rectum can be surgically removed. Depending on the size and location of the polyps, the procedure may be performed under local or general anaesthesia. All removed polyps are sent for histological examination (tissue analysis). Removal of adenomatous (precancerous) polyps helps prevent colorectal cancer.

Surgery is necessary if:

• the polyps cannot be removed endoscopically;
• he polyp is causing symptoms or discomfort.