Anal and Rectal Conditions

Anal/rectal conditions may have symptoms or signs of pain, bleeding, or discharge, and the most common of these are:

Abscesses are infected gland sites filled with pus. Typically, a colon and rectal surgeon will incise and drain the infected area. This is usually done as an office procedure, but may sometimes require hospitalization if there is an underlying condition, such as diabetes. About half the time, the abscess heals, and about the other half, a fistula results.

Anal fistulas are abnormal connections between the rectum and surrounding skin (a fistula describes any abnormal connection between an organ, vessel or intestine and another organ, vessel, intestine, or your skin). Many anal fistulae begin as anal abscesses, a pus-filled cavity near the anus or rectum. When the abscess bursts, it may cause a fistula. One of the most common treatments is a surgical procedure called an anal fistulotomy. Fistulae differ from patient to patient. The tunnel, or path, each fistula takes may vary. Your surgeon will need to determine how much muscle lies between the fistula tunnel and the skin’s surface before performing a fistulotomy.

Fissures are small tears in the skin of the anus. Fissures typically cause pain and often bleed during a bowel movement. Most fissures can be managed by adding more fiber to the diet to normalize bowel movements and medications to calm the pain and relax the sphincter muscle. Surgery is sometimes recommended when medication fails. To treat an anal fissure, your colon and rectal surgeon will place a small cut on one outside margin of the internal anal sphincter muscle, also called a lateral internal sphincterotomy. This decreases pain and spasm and allows the fissure to heal.

Hemorrhoids are swollen, painful veins located near your rectum or anus.

• Internal Hemorrhoids are veins around the anus in which increased venous pressure and/or the vein walls have weakened, resulting in bulging veins. With the repeated pressure of bowel movements, the veins may burst, causing bleeding. Minor hemorrhoids are managed by dietary changes. Advanced hemorrhoids that bleed and prolapse (stick out) need invasive treatments, including rubber band ligation and hemorrhoidectomy.

• External Hemorrhoids lie beneath the skin near the opening of the anus. These may become painful if one or more suddenly clot. If these are diagnosed within 48 hours, removal is appropriate. If diagnosed later, these clots will dissolve spontaneously often leaving a skin tag.

Pilonidal dimple is a condition that occurs on the crease of the buttocks. A pilonidal dimple is a broad term that includes:

• Pilonidal abscess, caused by an infected hair follicle
• Pilonidal cyst, formed when there has been an abscess for a long time
• Pilonidal sinus, caused by a tract, or tunnel, forming under the skin
• Pit or pore that contains dark spots or hair

These may become infected and cause intense pain and drainage. The treatment for pilonidal cyst is excision. Your surgeon completely removes the abscess and all of the infected tissue surrounding it. This is the most effective technique with the best chances for a complete cure. There are two options for healing:

• Open healing means your doctor leaves the wound open and does not close it with stitches. This allows the wound to heal on its own. The re-infection rate is very low. It takes a few weeks to fully heal and you need to pack the wound twice a day for the duration of the healing time.
• Closed healing means your doctor closes the wound with stitches. Healing time is faster and there is no packing or aftercare, but the infection rate is higher than with open healing. Because the wound was closed, if there is an infection, you may need to undergo surgery again to open the wound and let it heal on its own.

Rectal prolapse is a condition in which the ligaments and muscles around the rectum weaken. This causes the tissue lining the rectum and part of the large intestine to slip down through the anal opening. It occurs most often in young children and in the elderly.

If symptoms persist call Gastrocure in West Orange, NJ at 973-736-1112 to schedule an appointment