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About Anorectal Disease

This information is for educational purposes only and should not be relied upon as medical advice. It has not been designed to replace a physician's independent judgement about the appropriateness or risks of a procedure for a given patient.

Bleeding, pain, discharge and itch are some of the most common complaints of anorectal disease. Colorectal surgeons have extensive training and experience in the management of anorectal disease. At the office visit, a detailed history and physical examination is performed. This includes an examination of the anus and lower rectum. Once the examination is complete and a diagnosis is made, we will review the problem with you and devise a treatment plan that can cure the problem.

Below is a summary of some common conditions that can cause pain, bleeding, discharge and itching.

  • Hemorrhoids – Everyone has hemorrhoids! They are a normal part of the anal anatomy which help control bowel movements and gas. Hemorrhoids are divided into internal (inside) and external (on the skin) Hemorrhoids. When internal hemorrhoids are irritated they can enlarge and may cause discomort or bleeding. External hemorrhoids can present as an exquisitely painful lump on the anal skin. Once the diagnosis is made, the first line of treatment is usually dietary modification and/or the application of local hemorrhoid treatments in the office. Larger hemorrhoids may require an operation. Traditional surgery for hemorrhoids is offered, however it is a painful recovery. We are proud to offer a new stapled technique which causes significantly less post-operative pain for most patients.
  • Anal fissure – People who develop severe pain and occasional bleeding after a bowel movement may have an anal fissure, or tear in the anal skin. Generally, dietary and medical treatments can be prescribed in the office. For those people who do not respond, or for people who have had the symptoms for long time, a minor surgical procedure can be performed which can cure the problem.
  • Pilonidal Disease – People may develop an abscess or infection between the buttocks. Often this is due to infected hair follicles. Surgery aimed at relieving the infection can usually be performed in the office. Surgery to cure the problem may require an operation and subsequent wound care.
  • Anal abscess and fistula – Severe pain and swelling in the anal region can be caused by an anal abscess. The initial treatment involves draining the infection by inserting a small plastic drain under local anesthetic in the office. This gives almost instantaneous relief of symptoms. Some patients with an abscess may develop a fistula, which is a communication from the inside of the rectum to the anal skin. Patients who have a fistula or recurrent abscesses may require an examination under general anesthetic, which can be arranged at the initial visit. Definitive surgery to eradicate the fistula may be required at a later date.
  • Sexually transmitted diseases – Some patients who have anal infections may develop pain and/or bleeding. Patients also may have warts in the anal region which need to be removed as they can become cancerous. A thorough examination in the office, sometimes with additional input from the Infectious Disease Department will allow us to determine the best course of therapy.
  • Other conditions – People may have problems related to the skin around the anus. A complaint about persistent discomfort or itch in the anal area, despite excellent hygiene, is called pruritis ani. This can be treated with dietary advice and other suggestions.
  • Malignant tumors – In rare cases, patients develop a swelling or mass in the anal area which is caused by a cancer. Colorectal surgeons are experienced at defining the treatment regimes for such tumors which may involve chemotherapy or radiation prior to surgery, or simply proceed with the surgery if needed. The treatment plan is tailored to each individual.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

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