A surgeon talks to a patient in a hospital bed about recovering after colorectal surgery.

Colorectal surgery

Each year, millions of Americans are diagnosed with medical conditions that affect their colon, rectum or anus. These issues can cause significant challenges with digestion and bowel movements – and even impact overall health and well-being.

Colorectal surgery is often a key part of a personalized treatment plan for conditions that affect your lower digestive tract. You may be referred for colorectal surgery by a primary care doctor or another specialist, but there are also times when it makes sense to contact a colorectal surgeon directly.

Our patient-centered approach ensures each person’s experience is seamless, from initial consultation to post-operative care – and it shows. Our colorectal surgery program is nationally recognized. Plus, our colorectal surgeons are regularly honored as top doctors by Minnesota Monthly, and rising stars or top doctors by Mpls.St.Paul Magazine.

We care for conditions that affect your lower digestive system

Our colon and rectal surgeons specialize in the medical and surgical treatment of conditions involving the colon, rectum and anus. If colorectal surgery is part of a larger treatment plan, you can expect us to seamlessly partner with other specialists to provide comprehensive care. Our multidisciplinary approach to your treatment helps to reduce testing, costs and the chance that your condition comes back.

  • Anorectal conditions – Our team of colorectal surgery experts treat a range of conditions that affect your rectum, your anus and the surrounding skin. If you need treatment for anorectal conditions, making an appointment with a colorectal surgeon is a good place to start.
  • Cancer and polyps – As part of a multidisciplinary team, we treat patients who have precancerous polyps or been diagnosed with colorectal cancer or other cancers that affect the digestive system, including small bowel cancer and rectal cancer. We work closely with oncologists, gastroenterologists and other specialists to ensure that you get the best possible treatment.
  • Digestive disorders – We partner with gastroenterologists to ensure personalized and consistent care for people with diverticulitis or inflammatory bowel diseases (IBD) such as Crohn’s disease, ulcerative colitis and indeterminate colitis.

Colorectal conditions we treat

  • Anal fissures
  • Anal fistulas
  • Cancers of the colon, rectum, small bowel and anus
  • Colonic stenosis
  • Colonic volvulus
  • Diverticulitis
  • Fecal incontinence
  • Hemorrhoids
  • Inflammatory bowel disease (Crohn’s and ulcerative colitis)
  • Ostomy takedown/colostomy reversal
  • Pilonidal disease
  • Rectal prolapse
  • Skin irritation or warts around the anus

Anytime you have a new or unusual symptom it’s a good idea to schedule an appointment with a primary care doctor. If needed, they’ll refer you to another specialist for additional testing or treatment.

Symptoms of colorectal conditions differ from person to person but may include blood in stool, chronic constipation, lumps near or coming out of your anus, or pain during bowel movements.

If you have symptoms that could be caused by problems with your lower digestive tract, a colorectal surgeon may use different tests and exams, such as:

  • Physical exam – A first step in diagnosing colon and rectal conditions is usually a physical examination of the anal and rectal area to see if there are external hemorrhoids, warts, skin changes or signs that may indicate a colorectal condition.
  • Anoscopy – During this procedure, the doctor uses a scope, a narrow tube-like instrument with a light and a lens, to get a view of the very bottom of your digestive tract (the inside of the anus and lower rectum). High resolution anoscopy uses a more advanced scope that can find small changes that may not be visible during a standard exam, allowing for earlier detection of cancers and precancers.
  • Sigmoidoscopy – A sigmoidoscopy allows your doctor to see farther into your digestive tract than an anoscopy, to your lower colon. The procedure is done with a flexible scope.
  • Colonoscopy – During a colonoscopy, a gastroenterologist uses a flexible scope to look at your entire colon and rectum. Often, you’re awake for the procedure, but you’ll receive a mild sedative and pain killer to make it more comfortable. Colonoscopies are used to detect a range of conditions and for colorectal cancer screenings.
  • Blood tests – Blood tests are used with other tests and procedures to provide additional information that may be helpful in diagnosing or managing colorectal conditions. For example, elevated levels of specific markers may be signs of colorectal cancer or inflammatory bowel disease.

Colorectal surgeries and treatment

At HealthPartners, you can expect the most advanced surgical technologies, such as minimally invasive laparoscopic and robot-assisted surgery, as well as a treatment plan tailored to your individual needs. We’ll help you understand all of your treatment options, so you’re able to make the choice that’s right for you.

Rectal and colon cancer surgery

As part of treatment for colon or rectal cancer, a colorectal surgeon may remove precancerous or cancerous tissues during a colonoscopy or another procedure. Polypectomy and local excision are two of the most common surgeries for colorectal cancer.

Surgery isn’t always recommended for colorectal cancer. Depending on the type and stage of the cancer, your care team may try to manage the cancer with medications and periodic screenings.

Regions Hospital and Methodist Hospital are both recognized by the U.S. News and World Report as high-performing hospitals for colon cancer surgery.

Inflammatory bowel disease (IBD) surgery

IBD is chronic inflammation of the tissues in your intestinal tract. Often these conditions can be managed without surgery. But if other treatments don’t work for you, your gastroenterologist may refer you to a colorectal surgeon. There are different procedures and surgery for Crohn’s disease and ulcerative colitis (UC), that may be options depending on your individual needs.

  • Removing inflamed tissue – If your IBD symptoms are caused by inflammation in a certain part of your digestive tract, surgery may be used to remove the affected area.
  • Widening the intestinal passage – IBD can sometimes cause intestines to narrow and make your symptoms worse. During a strictureplasty procedure, your doctor makes incisions in the narrowed area and then sutures it back together in a way that widens the passage.
  • Adding a J-pouch in your digestive tract – For severe cases of ulcerative colitis, your doctor may recommend a surgery called restorative proctocolectomy with anal anastomosis (J-pouch). During this surgery, the entire colon and rectum is removed and then a pouch is created using the small intestine. This pouch is then connected to the rectum, allowing stool to pass out of your body in the normal way.

Diverticulitis surgery

Diverticulitis is an inflammation or infection of the pouches (diverticula) formed in the colon. Although the condition can often be managed through medications and lifestyle changes, your gastroenterologist may refer you to a colorectal surgeon if your diverticulitis is severe or life-threatening.

  • Removing part of the colon – Colectomy is surgery to remove the diseased part of the colon (usually the sigmoid colon) and then join the healthy parts together.
  • Colostomy formation – If it’s not possible to reconnect the parts of the colon because of disease or infection, your surgeon may make a colostomy, a surgical opening in your abdominal wall through which stool is rerouted into a special bag. This may be temporary or permanent, depending on your situation. At HealthPartners, we provide advanced techniques to prevent the need for a colostomy, whenever possible.
  • Emergency diverticulitis surgery – Perforated diverticulitis surgery may be performed when there’s severe infection and inflammation. This surgery involves removing the diseased area and cleaning the surrounding area to control infection and prevent complications.

Hemorrhoid treatment

Hemorrhoids are swollen vessels in the rectum or anus that can be painful or bleed. You may be able to treat hemorrhoids at home but if the hemorrhoids are painful, bleeding a lot or don’t go away, let us know. We’ll put together a personalized plan for hemorrhoid relief that may include:

  • In-office banding – The most common treatment is in-office banding, which involves putting small rubber bands around the base of a hemorrhoid. This cuts off the blood supply to the hemorrhoid and also reduces bleeding.
  • Hemorrhoid surgery – Surgery to remove hemorrhoids may be an option when other treatments haven’t worked, your hemorrhoids are large or severe, or if they keep coming back in the same place.

Anal fissure procedures

Anal fissures are small tears in the lining of the anus that can cause pain and bleeding during bowel movements. Fissures often heal on their own within a couple weeks but contact us if they don’t go away or are especially painful. Possible treatments include:

  • OnabotulinumtoxinA (Botox) injection – Injecting Botox in the anal sphincter muscle can help relieve spasms.
  • Sphincter surgery – Surgery may be recommended if other treatments don’t help. During a sphincterotomy procedure, the anal sphincter is cut or stretched, which can lessen the pain of anal fissures.

Fistula surgery

A fistula is an abnormal tunnel connecting one body cavity to another body cavity or to the skin. These abnormal connections can form in different parts of your digestive tract, including your rectum and intestines. Fistulas can cause problems such as infection, inflammation and pain.

Surgery is used to repair gastrointestinal and anal fistulas, and remove any infection. The choice of procedure depends on factors such as the location of the fistula, its complexity and your overall health.

Rectal prolapse repair

A rectal prolapse is where part of the rectum slips through the anus. This can happen if the muscles that hold the rectum in place get weak. If you have a rectal prolapse, you may also have other pelvic floor disorders. That’s why we work in a multidisciplinary manner with urogynecologists to provide the best possible treatments for your specific situation. Surgery, such as one of the following, may be recommended for rectal prolapse:

  • Attaching prolapsed tissue to the pelvic wall – During a robotic ventral mesh rectopexy surgery, the doctor pulls your rectum into the back wall of your pelvis and uses permanent stitches to hold it in place. This procedure is done through small incisions in your stomach.
  • Removing prolapsed tissue – During an Altemeier procedure, your doctor pulls the prolapsed rectum and sigmoid colon out through your anus, and then surgically removes them. The remaining part of the rectum is connected to your large intestines, allowing you to continue to pass stool normally.

Fecal incontinence (also called bowel incontinence) is a condition where you’re unable to control your bowel movements. There are many possible treatments for fecal incontinence that can help get you back to the life you want. Our colorectal surgery team will be there to support you every step of the way with treatments such as:

  • Diet changes – Treatment usually starts with making changes to your diet and trying over-the-counter medications to reduce diarrhea, add bulk to your stool and promote healthy gut bacteria.
  • Pelvic floor (Kegel) exercises – These exercises can strengthen the muscles responsible for controlling bowel movements. Biofeedback training can make you more effective when you do these exercises.
  • Bowel training – In some cases, having a regular toileting schedule can help train the bowels to empty at specific times, reducing the risk of accidents.
  • InterStim sacral neuromodulation (SNS) – InterStim is a small implantable device that sends electrical signals to the sacral nerves, which control bowel function. It can help regulate bowel movements and may improve continence.
  • Rectal irrigation – Transanal irrigation is a technique that involves using a catheter to flush the rectum with warm water. This can help regulate bowel movements and empty the rectum, reducing the risk of accidents.

Pilonidal disease treatment

A pilonidal cyst is an unusual pocket in the skin that almost always forms at the top of the buttocks near the tail bone. These cysts are usually caused by ingrown hairs and can be very painful. Possible treatments include:

  • Incision and drainage – Most of the time, these cysts can be treated in the office. After numbing the area, we’ll make small cuts to drain the cyst.
  • Surgery to remove cysts – Depending on your situation, there are a number of good surgical options available. Minimally invasive techniques are often appropriate. For larger cases, we offer pilonidal cystectomy which is the removal of the entire cyst. This surgery may be combined with a cleft lift procedure that reshapes the area above the tailbone, so that dirt and hair can’t collect there.

Treatment for skin irritation or warts around the anus

Skin irritation and warts around the anus can be uncomfortable and concerning. Our compassionate team is here to provide expert care and support throughout the treatment process, ensuring your comfort and confidentiality.

These conditions are highly treatable. In some cases, they can be managed with medicated creams and ointments. Other options include cryotherapy, electrocautery and surgical removal.

Colonic stenosis procedures

Colonic stenosis, or the narrowing of the colon, can lead to various digestive symptoms. We partner with gastroenterology to ensure the most appropriate treatment for your condition.

  • Endoscopic dilation – A common treatment is endoscopic dilation, a procedure that uses a flexible scope with a balloon to widen narrowed areas of the colon.
  • Stent placement – For more complex cases of colonic stenosis, we may recommend the placement of a stent. A stent is a small tube that helps keep the narrowed colon open.
  • Surgery for colonic stenosis – Surgery is usually reserved for severe cases or when other treatments don’t work. A common surgery is colonic resection to remove the narrowed segment and reconnect the healthy portions of the colon.

Colonic volvulus procedures

Colonic volvulus, a condition in which the colon twists on itself, can be a medical emergency where prompt diagnosis and treatment are necessary.

  • Colonoscopy – Sometimes a colonoscopy procedure can be used to identify colonic volvulus and also to untwist the colon.
  • Surgery for colonic volvulus – Surgery is often necessary to prevent colonic volvulus from coming back. Our experienced surgeons can perform procedures to untwist the colon, remove any damaged tissue and ensure the colon is properly secured to prevent future twisting.

Ostomy takedown surgery

Ostomy takedown surgery, also known as ostomy reversal or stoma closure, is a surgical procedure that involves reconnecting the digestive tract after a temporary diversion created by an ostomy.

Ostomy takedown surgeries are typically planned procedures that require careful evaluation by a colorectal surgeon. The decision to reverse an ostomy (such as a colostomy) is made based on various factors, including your overall health, the reason for the ostomy and the expected outcomes. These surgeries are often associated with improved quality of life, as they allow you to return to more normal bowel function and eliminate the need for external ostomy appliances.

How we’ll help you recover after colorectal surgery

Our post-operative care program is based on a set of guidelines called Enhanced Recovery After Surgery (ERAS) that is shown to improve patient recovery, lower complication rates, shorten hospital stays and reduce readmissions.

A key part of colorectal surgery recovery is to quickly get your body back to normal levels of digestion and movement. Shortly after surgery you’ll be drinking water and eating healthy foods – and be encouraged to move around as soon as you feel up to it. Before you go home, you will be getting out of bed, walking around and eating your meals while sitting in a chair.

During colorectal surgery recovery, you will receive pain medication to help you safely manage your pain. Whenever possible, we help people manage pain without narcotics since opioids can make your recovery harder.

Frequently asked questions (FAQs)