The advantage of clinics over large hospitals is their flexibility. When no other person is waiting in a clinic, it takes less than one hour for a patient to complete the first visit, including examinations such as endoscopy, because only several minutes are required for such an examination. Even if the clinic is a little crowded, it will take only 2 hours to complete the visit. Our clinic has an in-house pharmacy at which we dispense prescription drugs. The costs incurred are inclusive, so if they appear to be high, in reality they are not so, because the patient will not have to visit a pharmacy outside of our clinic to purchase medications. If a patient makes a first visit to our clinic and is prescribed drugs for constipation or hemorrhoids at our clinic, the patient will have to pay 10% (about 760 yen) or 30% (about 2300 yen) of all expenses depending on their health insurance coverage. Even if an endoscopy (including sigmoidoscopy) is performed on a patient presenting with bleeding, the patient’s self-payment will be about 1400 yen (10%) or 4200 yen (30%). With such amount of money, a correct diagnosis of hemorrhoids or colorectal cancer can be established with a considerably high probability. Such a cost is acceptable. If you are concerned about perianal conditions, visit a clinic as soon as possible “before it is too late for treatment.”
In our hospital, patients are given a number card at the reception desk and are called with the assigned number in consideration of personal information and privacy. At the initial visit, a physician performs history taking in the examination room and then examines the patient’s condition while the patient is in a recumbent position after taking off their lower garments. The patient is requested to cover the lower half of the body with a towel while waiting until the physical examination starts. Some patients are concerned about anal bleeding during treatment. Although a minor bleeding may occur in the presence of anal stenosis or anal fissure, bleeding will not be caused by the physical examination. After the physical examination, the doctor will give the patient an explanation about the condition and the instructions for use of drugs. About one hour will be required for the first visit to be completed from arrival to leaving our hospital although the required time may differ according to the scheduling on that day. The medical expenses are 2,000 to 3,000 yen for physical examinations and 2,000 to 3,000 yen for medications.
Treatment is performed on a case-by-case basis depending on the patient's symptoms. However, if the patient has typical hemorrhoids (piles), drug therapy is administered for the first 2 weeks after the initial examination to check for the drug's effectiveness. Some patients respond well to drug therapy and hemorrhoids are resolved in 2 weeks, whereas others respond to drug therapy but need longer treatment. After 2 weeks of treatment, such patients will continue to take the drug for about one month, receiving follow-up examinations. This treatment will cost approximately 30,000 to 40,000 yen. The period from the initial visit to the end of treatment is approximately one and a half months. If symptoms are not alleviated by drug therapy, other examinations will be recommended or surgery will be considered.
At the initial visit, patients are asked to fill out a questionnaire on their medical history and a proctologist performs history taking and physical examinations while checking it. After that, patients are asked to lie on their side for a thorough examination of the anus. Proctologists must examine not only the inside of the anus but also the perianal region. After that, a digital examination will be performed to check the lining of the anus. For the digital examination, proctologists insert a finger, touching the inside of the anus. After the digital examination, anoscopy is performed for confirmation. Only experienced proctologists can perform an anal examination. Therefore, hospitals where fully experienced proctologists are available are recommended.
At our hospital, the expenses for the initial visit will be about 2,000 yen, and about 5 minutes will be required for medical examinations. However, for patients presenting with bleeding, endoscopy may be performed on the day of the initial visit. In such cases, the time and expenses will differ. In the case of inpatient surgery, the hospitalization period will be about one week and the cost will be 70,000 to 100,000 yen.
