Proctology

Colorectal diseases can easily be confused, with most being misdiagnosed simply as hemorrhoids. Therefore, before any treatment, including over-the-counter creams and suppositories, an examination makes sense.

It must be confirmed whether it actually is hemorrhoids, thrombosis of the anal veins (blood clots on the anus margin), whether there is a fistula (inflammatory canal between the intestine and the skin’s surface) or fissure (tear in the mucous membrane). All of which are treated quite differently.

The important thing to remember is that there is no universal method of treatment. Depending on the stage of Hemorrhoids (1st-4th degree), individual anatomy and symptoms, we decide together which is the correct treatment plan for you. Due to embarrassment and fear, patients usually hold out much longer before visiting a doctor, when in reality it’s quite simple. For example, 1st and 2nd degree hemorrhoids can be remedied with a few weeks of conservative treatment, while 3rd and 4th degree hemorrhoids usually requiring a very minor outpatient procedure.

Piles are quite simply excess tissue that is left over from an inflamed hemorrhoid. Sometimes referred to as external hemorrhoids, they can cause itchiness and the occasional flare up of pain in the anal area. The removal, or hemorrhoidectomy, is usually done on an outpatient basis under either local or general anaesthesia. When the condition is less severe, treatment can be as easy as medicated ointments and creams, powders, and/or suppositories.

Perianal thrombosis (also called anal thrombosis) is a painful swelling of the anus caused by a blood clot in the superficial veins. Perianal thrombosis often results from prolonged sitting, sitting on cold surfaces, heavy or long presses during bowel movements (eg in hard stools or diarrhea), as well as during pregnancy and childbirth. They can also be caused by severe coughing, exercise, lack of fluids due to lack of drinking and even sneezing.

An anal fistulas is an inflammation of the rectum that can affect different numbers of the skin’s layers depending on severity. Occurrence of the fistula at the skin’s surface is not always present which can sometimes cause for misdiagnosis. Frequent causes are abscesses in the underlying tissue of ​​the anus / anal cavity, which provide access to the proctodeal (anal) glands. The glands located between the different parts of the sphincter muscle can then manipulate the sphincter with small canals in various ways. As a result, inflamed ducts are often visible on the skin of the anus, but may also be located towards the mucous membrane. Typical symptoms include the secretion of pus from the fistula openings, pain, swelling and fever.

Anal cancer is a malignant tumor in the anal canal. It often arises after previous damage to the anal region by fistulas, fissures and other abnormalities including genital warts (condylomas) or as a result of sexually transmitted diseases (including HPV). That’s not to say that fissures alone do not trigger cancer. They can however cause similar symptoms, mostly in the form of pain and regular bleeding. HPV (human papillomavirus) is detected in the majority of anal cancers and is sometimes referred to as ‘pre-cancerous’ as it causes an accumulation of abnormal cells that can grow out of control (tumors). Small biopsies of these tumors can be taken under local anaesthesia which can easily confirm the diagnosis of an anal cancer. The most effective treatment for anal cancer is combined chemoradiation. With radiation therapy, both the tumor area and the lymph nodes in the pelvis and groin are irradiated. As with most cancers, the sooner the disease is detected, the higher the chances of recovery.