When Dr. Hurtuk was doing his general surgical residency, he realized how important colorectal health is in the lives of patients. He jokingly tells his friends and family who ask why he pursued colorectal surgery as a specialty, “Everyone poops, and everyone takes this for granted until they can’t poop normally.” Because colon issues are extremely common, we decided to talk to him about colon health, problems patients experience and what he does as a colorectal surgeon.
What are simple ways to improve colon health?
Dr. Hurtuk says that it’s actually difficult to say what percentage of the American population has an undiagnosed colon issue. “There are so many issues out there ranging from the benign to the malignant,” says Dr. Hurtuk. So how do you know if you have a colon issue? He says to get screened. “It’s very important to get a colonoscopy at the age of 50, or younger if someone in your immediate family is diagnosed with a colon cancer or a colonic problem earlier. Signs and symptoms of something going on can be subtle, from feeling full early or feeling bloated after hardly eating, to losing a few pounds here and there without trying, to the more obvious: blood in the stool, abdominal pain or change in the appearance of stool. If any of these symptoms should arise, you probably should see your primary care physician. He or she will be able to sort through the normal and abnormal problems and refer you to someone who will be able to get the ball rolling on a treatment.”
What are the easiest ways to improve colon health?
Dr. Hurtuk recommends two simple ingredients—water and fiber. “For hemorrhoids and various anal and rectal complaints such as fissures, simple things such as fiber, increasing water in your diet and avoiding constipation could go a very long way. Anything with fiber is great to maintain a healthy colon. In order for fiber to be beneficial to you, it must be consumed with lots of water to do its thing in your colon. The key is to take in around 30 grams of fiber a day. If you can do it with the foods you eat, God bless you, otherwise, God created Metamucil and Citrucel,” says Dr. Hurtuk.
“When I tell this to patients, they don’t believe me and will sometimes even not listen. When I see those who do listen in follow up, they become very dedicated to fiber and water, even getting their friends to increase the fiber in their diet,” says Dr. Hurtuk. “I have a good friend who would never touch Metamucil until he started having problems. He called me and I told him my advice. He said jokingly if it wouldn’t work, he and I would no longer be friends. A year later, we’re still great friends, and he preaches the wonders of one glass of Metamucil twice daily to his family and other friends. Even during my colorectal training, the joke between me and my mentors was that Metamucil could put an anorectal surgeon out of business.”
What is Colorectal Surgery?
Dr. Hurtuk is both a general surgeon and a colorectal surgeon, so he is able to treat general surgical problems and colorectal problems. In case you wonder what the difference is between a colorectal surgeon and a general surgeon, the difference is in the training. A colorectal surgeon is a general surgeon who spends a year long residency or fellowship specializing in the treatment of problems related to the lower gastrointestinal tract including cancers, inflammatory conditions or infections, fecal incontinence, hemorrhoids, and fistulas among many other problems. After a general surgery residency and a colorectal residency, a colorectal surgeon can help treat anything that you think could go wrong with your digestive system. In terms of colorectal conditions, he diagnoses and treats:
- inflammatory bowel disease
- small bowel tumors
- colon and rectal cancer
According to Dr. Hurtuk, the colorectal residency or fellowship focuses on minimally invasive techniques in the operative treatment of problems of the lower gastrointestinal tract. A colorectal surgeon spends a year:
- Operating on the colon and rectum, learning various techniques that may not have been focused on during a general surgical residency. Some of these techniques involve laparoscopy, robotic surgery and endoscopic surgery as well as techniques on the treatment of low rectal cancers that allow the patient to get an adequate resection of their cancer while being able to live a normal life without a permanent colostomy.
- In the endoscopy suite learning how to perform colonoscopies and various interventions through colonoscopy.
- Learning nonsurgical techniques, such as diet and behavior modification to help better treat lower gastrointestinal problems.
Common Colon Screenings
If physicians suspect a problem with your colon, a few screenings that might be performed are:
- Colonoscopy. This should be performed starting at the age of 50, earlier if a close relative was diagnosed with colon cancer at an earlier age.
- Anoscopy. “With this screening, I’m able to visualize the anal canal for any growths or hemorrhoids. Typically, I will perform this for anyone with complaints of bright red blood per rectum,” says Dr. Hurtuk.
- Anal pap smears. This allows for detection of HPV around the anal canal. As in women, HPV can cause cancer in the anus, and it is important to be screened for high risk variants of the HPV virus. Those who should be screened are those who participate in anal sex, and those with a history of genital or anal warts, otherwise known as anal condyloma.
Surgery Techniques and Advances
Dr. Hurtuk is glad for the specialty he chose. “I’ve witnessed many changes in colorectal surgery from the time I was a medical student through my residency, and it’s an exciting field to be in. From the management of complex diseases to the evolution of technology to treat these diseases, it’s an evolving field,” says Dr. Hurtuk.
He currently is training to perform robotic surgery and should be able to do so by Spring 2015. He believes he will mainly use the robot for low rectal cancers and in patients who would not benefit from or who would have difficulty with laparoscopic techniques. “The jury is still out on the benefits of laparoscopic surgery vs. robotic surgery. Robotic surgery is such a new concept that the numbers and data are just coming in,” said Dr. Hurtuk. “I have done and published a few studies during my colorectal training looking at certain populations of patients and which ones would benefit from robotic surgery, and the results look promising. Indeed, it is an exciting time in minimally invasive surgery.”
Regardless of technological advances, Dr. Hurtuk always prioritizes the patient and the possibility for the best outcome. “I always treat each patient as an individual and do the safest thing for him or her,” says Dr. Hurtuk. “Currently, I offer a minimally invasive option to the majority of my patients, but the most important thing is not the technique, but the surgery itself, and the safety of the patient.”
Learn more about Dr. Hurtuk.
Dr. Hurtuk is currently accepting new patients. If you’d like to make an appointment to visit Dr. Hurtuk, call 708-422-8500.