Proctology

The treatment of colorectal diseases is one of our main priorities. Intestinal disorders are amongst the most common diseases with one in two adults being affected. Unfortunately, diseases of the rectum and large intestine are still a taboo topic in today’s society which makes it difficult to find the right help. Noone likes to admit that it itches or burns your butt – even those in extreme pain find it hard to reach out. In such situations, a trusted proctologist is required to get you the most professional and discreet treatment possible.

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Treatment:

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.

External Hemorrhoids (Piles)

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.

Anal Fissures

An anal fissure (fissura ani) is a painful tear of the skin or mucous membrane of the anus. It is generally most painful after bowel movements and can be alarming due to the presence of bright red blood. Stereotypically it affects the posterior position of the anal canal (6 o’clock lithotomy position) and runs radially (jet-shaped). The general cause is the rupture of the mucosa due to over exhaustion, for example after passing of hard stool due to constipation, or after a bout of diarrhea. Other causes can include straining during childbirth and lack of lubrication during anal sex.

Perianal thrombosis

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.

Fistulas

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 Carcinoma

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.