When a postpartum patient needs a proctologist

Abstract

Both pregnancy and delivery increase the risk of rectal symptoms in women. This is due to the increased severity of constipation in pregnant women, which is associated with hormonal factors, higher iron intake, limited physical exercise and weight gain during pregnancy. These factors promote haemorrhoidal disease, perianal venous thrombosis and hypertrophy of marginal anodermal folds. A pregnant or a postpartum patient reporting rectal symptoms becomes a multidisciplinary patient, with the overlap of two specialities, i.e. gynaecology and coloproctology. Most rectal conditions that occur in this special period of life may be managed conservatively and only some of cases require surgical approach. Therefore, obstetrician-gynaecologists with sufficient knowledge and experience in the diagnosis and treatment of the most common rectal conditions may implement treatment on their own instead of referring the patient to a proctologist. However, there are clinical situations when proctological consultation is necessary for medical and legal reasons. The paper describes the most common rectal conditions affecting postpartum patients, with an emphasis on situations requiring proctological consultation.