Frequently asked questions

Colorectal surgery deals with the diagnosis and treatment of disorders of the colon, rectum and anus — from benign polyps and haemorrhoids to cancer. Below are the questions our patients ask most often. If yours isn’t answered here, phone the rooms on +27 21 201 6582.

What are the symptoms of colorectal conditions?

Symptoms vary by condition and severity, but the ones that should always prompt a medical review are abdominal pain or cramping, blood in the stool, a change in bowel habits longer than 2 weeks, and unexplained weight loss. Early detection and treatment dramatically improve outcomes, so don’t wait for symptoms to “settle” — see a doctor.

What increases my risk of colorectal cancer?

Age is the biggest factor — risk rises significantly from the mid-40s onward. A family history of colorectal cancer or polyps, a personal history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis), smoking, heavy alcohol use, and a diet high in red and processed meat and low in fruit, vegetables and fibre all add to risk.

How are colorectal conditions diagnosed?

Beyond a careful history and examination, the main tests are:

• Colonoscopy — a thin, flexible camera examines the whole colon and rectum. Its great advantage is that abnormalities can usually be removed or biopsied on the spot.
• Sigmoidoscopy — a shorter examination of the rectum and lower colon. Simpler, but it can miss abnormalities higher up.
• Stool tests — can detect hidden blood or inflammation, screen for cancer, and diagnose infection.
• Endoanal ultrasound — the gold standard for assessing the anal sphincter muscles. It is simple, well tolerated, highly accurate at imaging the anatomy, and cost-effective compared with MRI. Our practice offers 3D endoanal ultrasound.

What are the treatment options?

Treatment depends entirely on the condition, is it a cancer and its stage — which is why the most important decision a patient makes is choosing an experienced colorectal team to plan it. The main options are:

Endoscopic resection — polyps and small lesions can be removed painlessly during a colonoscopy. A well-timed colonoscopy can spare you any further surgery.

Surgery — the mainstay of treatment for colorectal cancer and for many benign conditions. Wherever possible we operate with robotic or laparoscopic (keyhole) techniques for faster recovery.

Radiotherapy — used mainly before rectal cancer surgery to shrink the tumour and preserve surrounding structures, including the anal sphincters. In some cancers (such as anal cancer) it can achieve complete remission without surgery.

Chemotherapy — used before or after surgery to shrink tumours and treat microscopic cells that may have spread. The decision is nuanced and is best guided by a multidisciplinary team that includes your surgeon and oncologist from the start.

What can I expect after colorectal surgery?

Recovery time depends on the extent of surgery, whether radiotherapy came first, and your baseline fitness. A colonoscopy has a recovery measured in minutes; a major colonic resection takes weeks to return to normal function. We follow Enhanced Recovery (ERAS) principles — early eating, drinking and walking — which shorten hospital stays and reduce complications.

How can I prevent colorectal cancer?

Have a screening colonoscopy. Colorectal cancer deaths are preventable: screening detects cancer early when it is most treatable, and removes polyps before they can become cancer. International guidelines now recommend screening from age 45 for people at average risk — a position we support, individualised to your personal risk. Beyond screening: eat a diet rich in fruit, vegetables and whole grains and low in red and processed meat, exercise regularly, don’t smoke, and limit alcohol. Fitness also reduces the risk of complications if you ever need surgery.

When should I be screened if colorectal cancer runs in my family?

Family history moves screening earlier. As a guide: if a first-degree relative (parent, sibling or child) was diagnosed with colorectal cancer or advanced polyps, screening should start at age 40 — or 10 years before the age at which your relative was diagnosed, whichever comes first — and be repeated more frequently (typically every five years where the relative was diagnosed young). People with inflammatory bowel disease also need earlier and more regular surveillance. Discuss your specific family history with us and we will map out the right schedule.

How long will I be off work, and when can I drive?

It depends entirely on the procedure. A colonoscopy needs only the rest of the day (the sedation means no driving for 24 hours, and someone must take you home). Modern haemorrhoid procedures such as HAL or laser typically mean 24–48 hours off work; keyhole and robotic operations usually one to two weeks; larger open operations longer. As a general rule after any significant surgery, wait at least a week before driving — anaesthesia and pain affect judgement and reflexes — and avoid heavy lifting for about six weeks. You will get specific guidance for your operation before you go home.

Who do I contact after hours if I am worried after a procedure?

You will not be left without help: after any procedure you are given the practice’s after-hours contact arrangements, so you know exactly who to call at any hour. For emergencies, the Mediclinic Durbanville Emergency Centre (+27 21 980 2126) operates around the clock.

Do I need a referral to see you?

A referral letter from your GP or specialist is preferred — most medical schemes require one for specialist benefits — but it is not essential, and you are welcome to phone the rooms to discuss your situation.

Will my medical aid cover my procedure?

Most schemes cover medically indicated colonoscopy and colorectal surgery; many now fund screening colonoscopy from their screening and prevention benefits. Cover for robotic surgery varies by scheme and plan, and a growing number of schemes now support robotic-assisted colorectal surgery. Our rooms will confirm your scheme’s current position, help you obtain authorisation and any expected shortfall before any procedure.

What happens at a first consultation?

Expect a thorough history and examination, a review of any previous results you bring, and a clear discussion of what tests or treatment we recommend and why. Bring your referral letter, medical aid details, medication list and any prior scans or scope reports.