Proctology
Anal Region Diseases
What are the Hemorrhoids?
Hemorrhoids are growth, swelling, sagging, and bleeding in the vascular network, which is originally situated in the anus area. When we say “young people”, it means that every fourth person aged 20-40 years old, has this disease. Hemorrhoids are the same as varicose veins, which occur on the legs but are situated in the anus area.
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What are the causatives of hemorrhoids?
While the exact causative is unknown, the causes of the expansion of blood vessels and pressure increase around the anus may be constipation, excessive efforts during stool, long sitting in the toilet, pregnancy, long walking, or standing. Other causes may be certain genetic diseases, frequent diarrhea, and unconscious taking substances that soften stool.
What are the signs of hemorrhoids?
There may occur painful or painless swelling, elution, bleeding, and itching in the anus area. While inner hemorrhoidal boluses are usually painless, severe pain may appear in outer hemorrhoidal boluses after swelling due to the accumulation of grumes.
Can hemorrhoids turn into cancer?
Hemorrhoids cannot turn into cancer. However, it should be noted and never missed fact that the symptoms of intestine cancer and hemorrhoids are very similar, which may become a cause of the delay in early diagnosis of cancer. As soon as there are some changes in stool, one should immediately consult a general surgeon.
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How are hemorrhoids diagnosed?
The area of anus is checked for any thickenings, and outer hemorrhoidal boluses are monitored. After that, a rectal examination is performed, and cancer is eliminated, which may be a cause of bleeding. If the existing cause is inner hemorrhoidal boluses, the area of the anus can be examined more thoroughly through proctoscopy. The pain during and after stool usually accompanies the fissure of the anus.
What are the modern treatment modes for hemorrhoids?
To make the treatment effective, first of all, other causes that may cause bleeding should be eliminated (i.e. fissure of anus, rectal, and intestine cancer), and an illness must be localized properly. The treatment of hemorrhoids can be non-surgical and surgical.
In the first stage, through non-surgical treatment stool habits are corrected, diet is normalized, sitting hot bathes are taken, certain drugs are taken orally, and creams and suppositories are applied in the anus area.
In the 2nd and 3rd stages, laser, sewing, acupuncture, drying preparations (sclerotherapy), and infrared coagulation are applied, the methods that do not need hospitalization, and out-patient treatment is carried out quickly and easily with a high accomplishment quotient. Inappropriate sewing by inexperienced persons can cause severe pain. Therefore, this treatment mode must be applied only by experienced physicians.
In the 4th stage, operative intervention is inevitable.
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What is the anal fissure?
The anal fissure is called the fissure of the internal surface of the anal canal. It leads to severe pain, which lasts 15 – 20 minutes during and after the stool. Everyone can have fissures, but they are more common among young people and middle-aged people.
Detection of the anal fissure
The anal fissure diagnosis is easily made with the help of a rectal examination. With the help of the surveys called anoscopy and sigmoidoscopy, it can be established whether there are any cracks in the anus.
What are the symptoms of the anal fissures?
- Itching
- Pain, fever during and immediately after the stool
- Secretion
- Blood in the stool
What are the causes of the fissure of the anus?
- Constipation
- Long-lasting (chronic) diarrhea
- Crohn’s Disease
- Disorders of the Immune System
- Leukemia
What is the treatment for the anal fissure?
- Hot bath (in a sitting position)
- Consuming more fiber-rich foods to soften stool
- Substances that soften feces
- Hydrocortisone topical (suppositories or foam)
- Petrolatum
- Topical anesthetics for pain relief
- Nitroglycerin ointment/patch
- Injection of Botulinum toxin (Botox)
If the fissure treatment does not have a positive result, a surgical procedure is performed. In particular, such crack treatment operations as anal dilation and lateral internal sphincterotomy (LIS) are carried out. After these operations, as a rule, no hospitalization is required, or a maximum of 1 day of hospital stay is recommended. With the first stool after a properly performed operation, the pain is reduced by 80-90%.
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What is a perianal fistula?
An abnormal formation caused by an abscess that was previously formed between the colon area at the anus and the skin is called an anal fistula. Initially, one can distinguish four types of fistula. They are called extrasfincteric fistula, intershincteric fistula, transsfincteric fistula, suprasfincteric fistula. This disease is characterized by one or more 3-4 millimeter openings in the area of the anus and inflammation in them. The fistula has an external opening in the anus and an internal opening in the intestine. From time to time, the external opening closes and in this area, one can suffer swelling, pain, redness, and high temperature (abscess). When the external opening is opened by the person themselves or the doctor the client starts having complaints.
Diagnosis of perianal fistula
To diagnose the anal fistula, the anal area of the patient is examined. Also, for an accurate diagnosis, the anal canal is examined by pelvic MR or anoscopy. Complicated cases or cases with more than one fistula can be diagnosed by a special X-ray examination called a fistulogram. If previously there was a digestive system disease, sigmoidoscopy and colonoscopy may be required.
Also, when examining the area, an endorectal ultrasound (ERUS) is extremely useful.
What are the signs of a perianal fistula?
Pain in the sphincter area
Discharge in the sphincter area
Feces with blood
Itching in the sphincter area
Sphincter abscess
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