A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal, and perianal area by medical and surgical means. The specialty was known as proctology until 1961, when the name was changed to better reflect the specialty's focus. This specialist also deals with other organs and tissues (such as the liver, urinary, and female reproductive system) involved with primary intestinal disease. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses, and fistulae (infections located around the anus and rectum) in the office setting. Training also provides the specialist with in-depth knowledge of intestinal and anorectal physiology required for the treatment of problems such as constipation and incontinence. Colon and rectal surgeons also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths), and inflammatory conditions. Practitioners treat all age groups, but most of their patients are middle-aged and elderly. Their work typically involves a mix of techniques such as endoscopy and colonoscopy. New technology has made minimally invasive colon and rectal surgery possible, as well as improving diagnosis and treatment of inflammatory bowel disease, Crohn's disease, colon cancer, and other patient problems.