Topics & Treatments
Hemorrhoids
Hemorrhoids are veins in the anal region that everyone has and needs. We have internal and external hemorrhoids and they serve to clean and filter the anal region to prevent infections. When problematic, they can cause pain, bleeding, and protrusion. Depending on the symptoms, there are many different types of treatments. Treatments include band ligations, injections, and various types of surgery such as the non-cutting THD hemorrhoidectomy.
Rectal Bleeding
Bright red bleeding with bowel movements can be very worrisome. All rectal bleeding needs to be examined. Most of the time, bleeding is from hemorrhoids and anal fissures. Evaluation in the office with an anoscopy or a complete exam with a colonoscopy may be needed.
Rectal Prolapse
Rectal prolapse is a condition that usually occurs in elderly women where the rectum protrudes out of the anus. This can cause discomfort, bleeding, drainage and incontinence. Treatment for this condition requires surgery. Surgeries include both an abdominal and perineal approach to correct the problem.
Rectal Itching
Rectal itching is a very common condition that is very annoying but not life-threatening. There are many causes and often result from excessive wiping, scratching and perianal soap use. In addition, various foods can irritate the anal area. Treatment usually does not require surgery and can be easily fixed with conservative measures.
Fecal Incontinence
Fecal incontinence is a common symptom of elderly women. Causes include increasing age, neuropathy, and a weak pelvic floor. Symptoms can be very embarrassing and debilitating. Treatment is usually conservative with bulking agents and antidiarrheal medications. A very effective surgical option is available which involves neurostimulation of the sacral nerves.
Colonoscopy
Colonoscopy is a procedure that involves looking at the entire colon for diagnostic and therapeutic purposes. It involves cleaning your bowels out the night prior with laxatives and then go to an endoscopy center where a long scope with a camera and light examines the colon under anesthesia. Patient should start screening at 50 years old to remove any polyps that can turn into cancer.
Anoscopy
Anoscopy is a exam that uses a small tube that will look into the anus about 2 inches to evaluate any anal problems.
Constipation
Constipation is a very common condition that affects many patients. Causes may include a low fiber diet, poor water intake, medications, and certain medical conditions. Constipation is usually relieved with fiber, diet and laxatives.
Diarrhea
Diarrhea is a common condition that is usually classified under infectious causes and non-infectious causes. Infectious causes include bacterial, viral, fungal and parasitic infections. Non-infectious causes include various medical conditions. Treatment includes anti-diarrhea medications and treating the offending organism.
Anal Warts
Anal warts is caused by the Human Papilloma Virus (HPV). This the same virus that is tested for during a female PAP smear. Treatment involves chemical applications as well as surgery. Left untreated, anal warts can progress to anal cancer.
Ulcerative Colitis
Ulcerative colitis is a form of inflammatory bowel disease that involves the inner lining of the colon. The causes include both genetics and enviroment. Treatment is usually with medications to control the disease. Severe colitis may require surgery.
Abscess and Fistula
An anorectal abscess is an infection that originates from an anal gland that is just inside of the anus where the gland gets occluded. The infection spreads and extends out the the perianal skin. Treatment usually requires a drainage procedure. 50% of anal abscesses will develop into an anal fistula which would require a different type of surgery.
Bowel Incontinence
Fecal incontinence affects many women each year. Initial treatment includes fiber supplements and anti-diarrheal medications such as Imodium. If conservative measures do not work, the best treatment would be the insertion of a sacral nerve stimulator.
Anal Fissure
An anal fissure is a tear in the anus usually from a hard stool. Typical symptoms include rectal pain and bleeding with bowel movements. Treatment is usually conservative with laxatives and creams. If symptoms progress, then other options such as botox injections or surgery may be indicated.
Anal Cancer
Anal canal is a type of skin cancer that involves the anus. Anal canal often originates form the Human Papilloma Virus and anal warts. Once the diagnosis is made, treatment modalities include surgery and radiation with an excellent chance for cure.
Rectocele
A Rectocele is a condition in females where the rectum stretches out due to chronic constipation. The wall between the rectum and vaginal gets weaker with age and menopause and can cause a bulging of the rectal wall into the vagina. Treatment is usually conservative with laxatives and enemas. If symptoms progress, then surgical correction may be indicated.
Pilonidal Disease
Pilonidal disease is a condition that usually occurs in young males. The cause is suspected to be ingrown hairs in the gluteal cleft causing an infection under the skin through a network of tunnels. Symptoms include pain, bleeding, protrusion and drainage. Treatment is usually surgical excision.
Crohn's Disease
Crohn's disease is a form of inflammatory bowel disease that can affect any portion of the GI tract. Common symptoms include abdominal pain, diarrhea and anal problems. Many patient require medications and biologics to control the disease. Many patient will require surgery to removed the inflammed portions the intestines.
Pruritus Ani
Pruritis ani is a condition where the patient experiences itching in the anal region. There are many causes but mostly arise from excessive wiping after bowel movements, excessive scratching, and excessive soap use to clean the area. Treatment is with lifestyle modifications, creams and conservative measures. Surgery is usually not required for this condition.
Diverticulitis
Diverticulitis is a infection caused by a microperforation of a diverticulum that outpouches from the colon wall due to excess pressure. Symptoms include abdominal pain, fevers and diarrhea. Diverticulitis typical responds to antibiotics but may need surgery if symptoms do not resolve or if the patient continues to have multiple attacks.
Colon Cancer
Colon cancer is the 2nd leading causes of cancer-related deaths in the United States. It usually arises from a benign polyp in the colon and takes about 10-15 years to become a cancer. Symptoms include abdominal pain, rectal bleeding, contipation and weight loss. Diagnosis is usually during a colonoscopy. Treatment is primarily surgical followed by chemotherapy if spread has occured.
Rectal Cancer
Rectal cancer is similar to colon cancer but involves the last 15cm of the intestinal tract. Symptoms include rectal pain, bleeding and constipation. Diagnosis is usually during a colonoscopy. Treatment usually requires radiation and chemotherapy followed by surgery.
Inflammatory Bowel Disease
Inflammatory bowel disease is an autoimmune conditions where the patient's immune system sends antibodies to attack the patient's own intestinal tract. Two forms of inflammatory bowel disease includes Ulcerative colitis and Crohn's disease.