What Conditions Does a Colorectal Surgeon Treat?

Colorectal Conditions and Their Symptoms

Colorectal surgeons assess a range of conditions affecting the colon, rectum and anus. Some primarily cause bowel symptoms, while others may be found during screening or investigations performed for another reason.

Colon Cancer

Colon cancer develops in the large intestine and may not cause noticeable symptoms in its early stages. Possible signs include blood in the stool, persistent changes in bowel habits, abdominal discomfort, unexplained weight loss and fatigue. A colorectal surgeon may be involved in the diagnostic and staging process and in surgical treatment when appropriate, while care may also involve other specialists.

Colon Polyps

Colon polyps are growths that form on the inner lining of the colon or rectum. Most do not produce symptoms and are found during a colonoscopy, although some may cause bleeding or changes in bowel habits. While many polyps are benign, certain types can develop into cancer over time. A colorectal surgeon can assess polyps and determine whether removal, surveillance or further treatment may be appropriate.

Piles (Haemorrhoids)

Piles (Haemorrhoids) develop when haemorrhoidal tissue in or around the anal canal becomes enlarged or swollen. They may cause bright-red bleeding, itching, discomfort, a lump near the anus or tissue that protrudes during a bowel movement. As rectal bleeding can have causes other than piles, an assessment may be needed to confirm the diagnosis before suitable treatment is recommended.

Anal Fissures

An anal fissure is a small tear in the lining of the anal canal. It commonly causes sharp pain during or after a bowel movement and may leave a small amount of bright-red blood on toilet paper or the stool. Assessment can help distinguish an anal fissure from other causes of anal pain and bleeding, particularly when symptoms persist or recur.

Anal Fistulas

An anal fistula is an abnormal passage between the anal canal and the skin near the anus, often developing after an anal abscess. Symptoms can include recurring pain, swelling, skin irritation or persistent discharge from an opening near the anus. Specialist assessment can help determine the fistula’s path and guide treatment while considering the potential effect on bowel control.

Perianal Abscess

A perianal abscess is a collection of pus caused by an infection near the anus or rectum. It may cause constant or worsening pain, redness, swelling, fever or a tender lump. Because a perianal abscess may require drainage and can sometimes lead to an anal fistula, suspected cases should be assessed promptly.

Diverticular Disease

Diverticulosis occurs when small pouches, known as diverticula, form in the wall of the colon. When these pouches cause symptoms, bleeding, inflammation or other complications, this may be referred to as diverticular disease. Colorectal assessment may be appropriate for recurrent or complicated diverticular disease, particularly when it is associated with an abscess, narrowing, fistula, perforation or significant bleeding.

How Are Colorectal Conditions Diagnosed?

Diagnosis usually begins with a discussion of the patient’s symptoms, bowel habits, medical history and family history. The colorectal surgeon may then examine the abdomen and perform an examination of the anal and rectal area when appropriate.

Depending on the symptoms and initial findings, further investigations may include anoscopy, proctoscopy, colonoscopy, blood tests, stool tests or imaging such as a CT or MRI scan. Not every patient requires every test. The investigations selected depend on the suspected condition and help guide further management.

How Does a Colorectal Surgeon Treat These Conditions?

Treatment is tailored to the condition, its severity, the patient’s symptoms and overall health. Options can range from conservative management and clinic-based procedures to surgery when appropriate.

Medication and Conservative Management

Milder conditions may improve with dietary changes, measures to support regular bowel movements, medication or monitoring. For example, treatment may focus on making stools easier to pass, reducing inflammation or relieving symptoms. The recommended approach depends on the condition, how long symptoms have been present and whether previous treatment has helped.

Clinic-Based and Endoscopic Procedures

Some colorectal conditions can be treated without major surgery. Options may include clinic-based procedures for piles or endoscopic removal of suitable colon polyps during a colonoscopy. The recommended procedure depends on factors such as the type, location and severity of the condition.

Colorectal Surgery

Colorectal surgery may be recommended for conditions such as colorectal cancer, complex polyps, anal fistulas, perianal abscesses or complicated diverticular disease. The type and extent of the procedure vary considerably depending on the condition. For operations involving the colon or rectum, surgery may be performed using open, laparoscopic or robotic techniques. The surgeon will discuss the possible benefits, risks and expected recovery before recommending a procedure.

Follow-Up and Preventive Care

Follow-up may be needed to monitor recovery, check whether symptoms have returned or identify new problems. Patients who have had colon polyps or colon cancer may also require surveillance colonoscopies based on their previous findings and individual risk.

Comprehensive Colorectal Care With Dr Kam Ming Hian

Persistent or recurring bowel and anal symptoms may warrant further assessment, particularly when their cause is unclear or initial treatment has not helped. A colorectal consultation can help identify the underlying condition and determine whether conservative care, a clinic-based procedure or surgery may be appropriate.

At Kam Colorectal Centre in Singapore, colorectal care is provided under the care of Dr Kam Ming Hian, who assesses and treats a range of conditions affecting the colon, rectum and anus. If you have ongoing colorectal symptoms or would like further assessment, arrange a consultation to better understand your condition and the treatment options that may be appropriate for you.

Frequently Asked Questions (FAQs) About Seeing a Colorectal Surgeon

Meet Our Colorectal Specialist in Singapore

Dr Kam Ming Hian

Senior Consultant Colorectal Surgeon

MBBS (Singapore), M.Med (Surgery), FRCSEd, FAMS

Dr Kam Ming Hian is a senior consultant colorectal surgeon with more than 20 years of clinical experience. Formerly Director of Robotics and Minimally Invasive Surgery at Singapore General Hospital, he has experience in laparoscopic and robotic-assisted colorectal surgery. He has also performed thousands of endoscopic procedures, including colonoscopy and gastroscopy.