Current care for proctological complaints and pelvic floor physical therapy in a one-time consultation: a national survey among general practioners, surgeons, gastroenterologists and pelvic floor physical therapists

Abstract Background Proctological complaints are very common and can significantly impair quality of life. It is not known how these problems are currently treated by general practioners (GPs). While most cases improve with conservative treatment, some persist or recur and require specialist referral. GPs rarely assess pelvic floor dysfunction, despite its potential contribution to recurring symptoms. A one-time consultation with a pelvic floor physical therapist could help to close this gap and improve care efficiency. Objectives The study aimed to evaluate current GP practices in managing proctological complaints, such as hemorrhoids, chronic anal fissure and fecal incontinence. Additionally, this study assessed the willingness of healthcare professionals to implement a one-time pelvic floor physical therapist consultation. Methods GPs completed a questionnaire on diagnostic approaches, treatment and referral habits. Gastrointestinal surgeons, gastroenterologists, pelvic floor physical therapists, and GPs were also surveyed about their attitudes toward introducing a pelvic floor physical therapist consultation. Results Responses were received from 73 GPs, 27 surgeons, 6 gastroenterologists, and 56 pelvic floor physical therapists. GPs asked about urological problems in 36% and sexual complaints in only 7% of cases. Digital rectal examination was done by 47% of GPs, but only 3% assessed the pelvic floor muscles. Over 59% of GPs advised on lifestyle and toilet behaviour. In the past year, 47% referred 10–25% of patients to a specialist. Support for a one-time pelvic floor physical therapist consultation was high among GPs (82%), surgeons (82%), gastroenterologists (66%), pelvic floor physical therapist (88%). Key reasons included time constraints, knowledge gaps, improved care, and cost-effectiveness. Conclusions Dutch GP-guidelines are generally followed. There is strong support for integrating a one-time pelvic floor physical therapist consultation into the care pathway for proctological complaints.