Anal Region Diseases

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Anal Region Diseases

What are hemorrhoids?

Hemorrhoids are growth, swelling, sagging, bleeding in vascular network, which is originally situated in the anus area. When we say “young people”, it means that every fourth person at the age of 20-40 years old, has this disease. Hemorrhoids are the same as varicose veins, that occur on the legs, but situated in the anus area.

What are the causatives of hemorrhoids?

While the exact causative is unknown, the causes of expansion of blood vessels and pressure increase around the anus may be constipation, excessive efforts during stool, long sitting in the toilet, pregnancy, long walking or standing. Other causes may be certain genetic diseases, frequent diarrhea, unconscious taking substances which soften stool.

What are the signs of hemorrhoids?

There may occur painful or painless swelling, elution, bleeding, itching in the anus area. While inner hemorrhoidal boluses are usually painless, a severe pain may appear in outer hemorrhoidal boluses after swelling due to accumulation of grumes.

Can hemorrhoids turn into cancer?

Haemorroids cannot turn into cancer. However, it should be noted and never missed the fact that the symptoms of intestine cancer and hemorrhoids are very similar, what may become a cause of the delay in early doagnosis of cancer. As soon as there are some changes in stool, one should immediately consult a general surgeon.


How are haemorroids diagnosed?

The area of anus is checked for any thickenings, outer hemorrhoidal boluses are monitored. After that, rectal examination is performed, cancer is eliminated, what may be a cause of bleeding. If the existing cause are inner hemorrhoidal boluses, the area of anus can be examined more thoroughly by means of proctoscopy. The pain during and after stool usually accompanies the fissure of anus.


What are the modern treatment modes for hemorrhoids?

In order to make treatment effective, first of all other causes which may cause bleeding, should be eliminated (i.e. fissure of anus, rectal and intestine cancer), an illness must be localized properly. The treatment of haemorroids can be non-surgical  and surgical.

On the first stage, by means of non-surgical treatment stool habits are corrected, diet is normalized, sitting hot bathes are taken, certain drugs are taken orally, creams and suppositories are applied in anus area.

On the 2 and 3 stage, laser, sewing, acupuncture, drying preparations (sclerotherapy) and infrared coagulation are applied, the methods which do not need hospitalization, and out-patient treatment is carried out quickly and easily with a high accomplishment quotient. Inappropriate sewing by inexperienced persons can cause severe pain. Therefore, this treatment mode must be applied only by experienced physicians.


On the 4 stage, operative intervention is inevitable.

 What is a perianal fistula?

An abnormal formation caused by an abscess that was previously formed between the colon area at the anus and the skin is called an anal fistula. Initially, one can distinguish four types of fistula. They are called extrasfincteric fistula, intershincteric fistula, transsfincteric fistula, suprasfincteric fistula. This disease is characterized by one or more 3-4 millimeter openings in the area of the anus and inflammation in them. The fistula has an external opening in the anus and an internal opening in the intestine. From time to time, the external opening closes and in this area one can suffer swelling, pain, redness and high temperature (abscess), and when the external opening is opened by the person themselves or by the doctor the client starts having complaints.

What are the signs of a perianal fistula?

Pain in the sphincter area

Discharge in the sphincter area

Feces with blood

Itching in the sphincter area

Sphincter abscess


Diagnosis of perianal fistula

To diagnose the anal fistula, the anal area of the patient is examined. Also, for an accurate diagnosis, the anal canal is examined by pelvic MR or anoscopy. Complicated cases or cases with more than one fistula can be diagnosed by a special X-ray examination called a fistulogram. If previously there was a digestive system disease, sigmoidoscopy and colonoscopy may be required.

Also, when examining the area, an endorectal ultrasound (ERUS) is extremely useful.


Treatment of perianal fistula


The treatment involves eliminating the canal that forms the fistula. After determining the level of the fistula, which can be cured by surgical methods, a decision is made as to how the treatment will be carried out. The main surgical options are a mesh suture, fistulotomy, fistulectomy and the application of a covering skin flap.

 What is the anal fissure (fissures)?

The anal fissure is called the fissure of the internal surface of the anal canal. It leads to severe pain, which lasts 15 – 20 minutes during and after the stool. Everyone can have fissures, but they are more common among young people and middle-aged people.

What are the symptoms of the anal fissures?


Pain, fever during and immediately after the stool


Blood in the stool


Detection of the anal fissure

The anal fissure diagnosis is easily made with the help of a rectal examination. With the help of the surveys called anoscopy and sigmoidoscopy, it can be established whether there are any cracks in the anus.


What are the causes of the fissure of the anus?


Long lasting (chronic) diarrhea

Crohn’s Disease

Disorders of the Immune System



What is the treatment for the anal fissure?

Hot bath (in a sitting position)

Consuming more fiber-rich foods to soften stool

Substances that soften feces

Hydrocortisone topical (suppositories or foam)


Topical anesthetics for pain relief

Nitroglycerin ointment / patch

Injection of Botulinum toxin (Botox)


If the fissure treatment does not have a positive result, a surgical procedure is performed. In particular, such crack treatment operations as anal dilation and lateral internal sphincterotomy (LIS) are carried out. After these operations, as a rule, no hospitalization is required, or a maximum of 1 day of hospital stay is recommended. With the first stool after a properly performed operation, the pain is reduced by 80-90%.