Anorectal conditions may have symptoms or signs of pain, bleeding or discharge.
The most common anal/rectal conditions are one of the following:
An anal fissure is a small tear 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.
However, sometimes surgery is 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 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.
An anal abscess is an infected gland site 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 sometimes may require hospitalization if there is an underlying condition like diabetes. About half the time the abscess heals and about half the time a fistula results.
An anal fistula is formed from an anal abscess. The fistula is a tract (tunnel) connecting a skin opening, and an anal gland where the abscess formed originally. Surgical treatment of a fistula usually involves opening the tract and letting it heal from the inside.
A Pilonidal Cyst is an abscess in the cleft between the buttocks. These cysts may become infected and cause intense pain and drainage. Treatment of the abscess usually includes incision and drainage. Later, surgery is performed to excise the cyst. The wound is left open to drain and is packed with gauze.