Anorectal diseases include a number of illnesses located in the anus (the opening of the anal canal) and lower rectum (the portion of the large intestine just proximal to the anal canal). Surgical Associates treat a range of these common diseases including hemorrhoids, fissures, perianal abscesses and fistulas and anal pain.
Hemorrhoids are large, saclike blood vessels similar to varicose veins located in and around the anus and lower rectum and thus may be internal (inside the anus) or external (outside the anus). Risk factors to hemorrhoids include aging, chronic constipation or diarrhea and pregnancy.
External hemorrhoids may produce a painful swelling or a hard lump near the anus due to a blood clot. Internal hemorrhoids may cause bleeding (bright red blood on stool or toilet paper) or itching and may protrude through the anus causing pain and irritation.
Our surgeons will evaluate you and determine which treatment is best for you based on your age, health, medical history, extent of your condition, and your tolerance for certain treatments and medicines. Most hemorrhoids respond to non-surgical treatment such as increasing intake of dietary fibers and avoiding constipation, taking warm sitz (tub) baths and using certain creams to help shrink hemorrhoids.
Acutely swollen external hemorrhoids may need to be opened up to remove the blood clot and relieve the pain. This may be done in the office.
Occasionally, large internal hemorrhoids and those which continue to cause severe bleeding, pain or protrusion despite good medical treatment. may need to be surgically removed. Our experts will remove hemorrhoids using a number of techniques, including:
- Rubber Band Ligation: This is an office procedure where a rubber band is placed around the bottom of the hemorrhoid inside the rectum, which cuts off blood flow to the hemorrhoid, causing it to slowly shrink and degenerate within a few days.
- Transanal Hemorrhoidal Dearterialization: THD uses a suture to tie-off the blood flow to the hemorrhoid allowing it to shrink without excision of tissue. The procedure is offered as an out-patient surgery and is associated with minimal discomfort. For more information, visit www.THDAmerica.com
- Hemorrhoidectomy: This is the most radical procedure where the hemorrhoid is surgically excised and the area sutured closed. It is usually an outpatient surgical procedure but is associated with pain and a period of inactivity.
Other Anal Diseases
Anal Fissure is a small tear in the lining of the anus which causes anal pain as well as bleeding and itching. It is frequently related to hard bowel movements, diarrhea and inflammation in the anorectal area. Most fissures heal with non-surgical treatments such as medicated topical ointments. Surgery is sometimes required and is an outpatient operation that consists of partially dividing the underlying sphincter muscle in order to relieve the spasm which contributes to the fissure
Perianal or Perirectal Abscess is an infected cavity filled with pus found near the anus or the rectum, usually secondary to an infected gland. An abscess causes constant pain, swelling, pus drainage and/or fever. An abscess requires surgical drainage of the pus by making an opening in the skin near the anus to relieve pressure. This procedure is usually done on an outpatient basis.
Anal Fistula, or fistula-in-ano, is a small, abnormal tunnel connecting the anal canal or rectum to the skin near the anus and results in persistent drainage. It often results from perianal and perirectal abscesses. Surgical treatment is needed to cure an anal fistula and consists of a fistulotomy which opens the fistula tunnel. and converted it to a groove, which allows the fistula to heal from the inside out.
Pilonidal disease is an infection in the buttock crease area near the tailbone resulting from a reaction to hairs embedded in the skin. Most patients present with an abscess due to an acute infection of a pilonidal cyst where the area becomes red, tender and with foul smelling drainage; this requires surgical drainage usually performed in the office with local anesthesia. Patients with recurrent abscesses or non healing sinuses may require an excision of the pilonidal cyst.