EN
A proctologist treats conditions of the anus and rectum, the very complaints people tend to put off: they are embarrassed, treat themselves and delay seeing a doctor until it is hard to bear. A proctologist in Germany starts by calmly working out what is going on and, where possible, manages with a small intervention.
Rectal and pelvic floor disease sits where several specialities meet, so proctology in Germany rarely works alone: surgeons, gastroenterologists, urologists and gynaecologists are close at hand. This page covers who to see, diagnosis, treatment, hospitals and doctors, and how a visit is arranged.
Who a proctologist is in Germany and when to see one
In Germany a proctologist is a doctor with a main speciality plus the additional qualification in proctology (Zusatzbezeichnung Proktologie). Under the model rules of the German Medical Association, surgeons, gastroenterologists, dermatologists, gynaecologists, urologists and some other specialists can obtain it. Proctologists treat diseases of the rectum and anus, including skin conditions and infections there, as well as pelvic floor and bowel control problems, in practices and hospitals.
People come with blood when passing a stool, pain, itching, discharge, lumps at the anus, incontinence, constipation or a feeling of incomplete emptying. Self-diagnosis is risky: blood may mean harmless haemorrhoids or a disease that must not be missed, and only a doctor can tell which.
First, an accurate diagnosis
Treatment starts only once the diagnosis is clear, because similar symptoms easily mislead. After an examination, the doctor inspects the anus and rectum through a fine instrument (anoscopy and rectoscopy) and, where needed, adds colonoscopy of the whole large bowel and ultrasound. For incontinence, the pelvic floor muscles and nerves are tested.
Colonoscopy also finds polyps, small growths of the bowel lining that can turn malignant over the years; a polyp removed in time is in effect a tumour prevented. Where organised programmes exist, the WHO calls regular screening the most effective way to detect colorectal cancer early and prevent it, by finding and removing precancerous lesions. If a tumour is found, the next step is colorectal cancer treatment; other bowel conditions are covered under gastroenterology in Germany.
Treatment: from the simple to the complex
Treatment moves from the simple to the complex: routine, diet and topical remedies first, which for many people is enough, then the gentlest suitable intervention if one is needed. The extent of treatment is set after the examination, so a good hospital does not promise to “deal with everything in one visit”.
Haemorrhoids, the commonest reason for a visit, are treated by stage: minor procedures in the consulting room without incisions early on, surgery later when these no longer help. The methods are described on the page on haemorrhoids treatment.
Anal fistulas and fissures need particular care: the problem has to be removed without damaging the sphincter, the muscle responsible for continence, so experienced specialists operate. Pelvic floor disorders, from incontinence to pelvic organ prolapse, are treated at certified centres where surgeon, urologist and gynaecologist work together.
Proctology in Germany: where treatment happens and who operates
Proctology is practised in departments of general hospitals and in specialised clinics; look for certification and joint work between specialities. Continence and pelvic floor centres (Kontinenz- und Beckenbodenzentren) are certified by the relevant German society, and their doctors review difficult cases together; surgical coloproctology centres are certified by the German Society for General and Visceral Surgery (DGAV). In Munich, Klinik Josephinum has a proctological surgery department. At ISAR Klinikum, also in Munich, gastroenterology is headed by PD Dr. med. Holger Seidl, whose fields include proctology.
Prof. Mia Kim is chief physician for visceral surgery and coloproctology at München Klinik Harlaching, holds the additional qualification in proctology and is a Fellow of the European Board of Coloproctology (EBSQ Coloproctology). In Hamburg, Dr. Thies Daniels heads general, visceral and tumour surgery at Albertinen Hospital; in 2015 the department was certified as a competence centre for surgical coloproctology. These are examples, not a ranking.
Frequently asked questions
How should I prepare for a first appointment with a proctologist?
Gather earlier reports, test results and a list of your medicines, and note your symptoms and when they began. Mention blood thinners in particular: they decide whether a tissue sample can be taken or a polyp removed at once. Rectoscopy is usually preceded by a small enema, colonoscopy by bowel cleansing as the hospital instructs.
Is an examination by a proctologist painful?
Usually not: the examination and anoscopy can be unpleasant but are rarely painful, and they are over quickly. If a fissure or inflammation makes even a touch painful, the doctor uses an anaesthetic gel or postpones part of the examination. Colonoscopy can be done under sedation, a medication-induced sleep, so the patient hardly notices it.
Can I ask for a doctor or interpreter of my own sex?
You can ask, though the request cannot always be met. AlenMed arranges an interpreter of the same sex where possible. With doctors it is harder, since patients see whoever works in the department, so the wish is passed on when booking and weighed when choosing the hospital. Mention it in your first message to keep more options open.
How is a proctologist different from a gastroenterologist?
A gastroenterologist treats the whole digestive tract, from the oesophagus to the large bowel, plus the liver and pancreas; a proctologist deals with its last section, the rectum and anus, and with the pelvic floor. The fields overlap, since a German gastroenterologist can also qualify in proctology. Bleeding, pain or lumps at the anus are a matter for a proctologist, abdominal pain and indigestion for a gastroenterologist.
How AlenMed arranges a visit to a proctologist
AlenMed keeps the process discreet: the request can be described in writing rather than over the phone, and we translate reports and test results into German so the doctor sees the medical history in advance.
We book the proctologist or hospital, send a cost estimate, prepare a visa invitation letter if needed, help with accommodation and provide an interpreter, of the same sex on request where possible. AlenMed’s office is in Munich; the other steps are explained under arranging treatment in Germany.
After a procedure or operation the patient receives a report in their own language and stays in contact with the doctor: we pass questions on to the hospital and translate the answers.
This material is for information only and is not an offer. The treatment plan is decided by a doctor at an in-person consultation, after an examination.