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We find them embarrassing and we are ashamed to talk about them. Meanwhile, diagnosed too late anorectal diseases can cause serious complications and even death. Therefore, despite embarrassment, we should not delay visiting a proctologist.
How are end-digestive diseases manifested? It is primarily rectal bleeding, pain, itching, incomplete bowel movements, diarrhea and constipation. The rhythm of bowel movements also changes, the appearance of stools, lumps, growths, wounds appear. The most famous diseases in this area of the body are varicose veins and anal cancer. It is worth knowing that there are others: fistulas, fissures and proctitis.
Hemorrhoids – a disease of the obese and sedentary
The most common proctological ailment affecting every third Pole is haemorrhoidal varicose veins. They are usually manifested by bleeding and burning, and in the advanced stage of the disease – by the loss of varicose veins during exercise or defecation.
Who is the statistical owner of hemorrhoids? She is a woman in her fifties, spending the day sitting, not doing sports, preferring chocolates over carrots. Slightly obese, complaining of constipation. In women, hemorrhoids may appear earlier – during pregnancy or after childbirth.
Varicose veins can be treated with surgery and invasive non-surgical procedures, i.e. photocoagulation, cryotherapy, and sclerotherapy. Ointments, creams and suppositories bring relief, but they are not a substitute for visiting a doctor.
Changing your lifestyle is the easiest way to prevent varicose veins and even cure them at an early stage. The basis is exercise and a diet rich in fiber and plenty of fluids.
Fissures, fistulas and infections
When the main ailments are pain, especially associated with defecation, burning in the anus, and rarely bleeding – it can be suspected that the cause is an anal fissure, i.e. a shallow, narrow rupture of the anal canal mucosa caused by heavy exertion, usually the result of mechanical trauma, constipation or anal intercourse.
Similar symptoms are also characteristic of an anal fistula. It is a narrow canal lined with granulation tissue, with an inner opening in the anal canal and an outer opening on the skin surface. In addition to pain and burning, there is a permanent or temporary purulent discharge and an accompanying unpleasant smell. An anal fistula is usually formed when an anal fistula breaks to the surface of the skin or an abnormal incision is made of a perianal abscess. Abscesses are caused by infection of Hermann’s anal glands. It’s the same with fistulas, but they can also appear as a complication of Crohn’s disease.
The method of treating abscesses is their incision, and fistulas also require surgical treatment. In the case of an anal fissure, in the first phase, it is recommended to avoid irritation of the affected area, take care of regular bowel movements, a fiber-rich diet, and observe the rules of hygiene. This usually leads to the wound healing itself. Sometimes it is necessary to perform a surgery involving cutting a slit. Of course, the decision is made by the doctor.
Each of the ailments at various stages and in the subsequent stages of treatment may require drugs: anti-inflammatory and analgesic, stool softeners, laxatives. Ointments that facilitate healing and herbal baths will also be helpful. In the case of infectious proctitis due to viruses, bacteria and allergies, treatment is based on the use of drugs appropriate to the cause.
Other diseases manifested by pain in the area of the anus are inflammation of the prostate gland, uterus, abscess of the fallopian tube, endometriosis. One should also remember about post-traumatic pain (e.g. coccyx) and pain related to the degeneration of the lumbosacral spine.
ANTALANCER CANCER – CURE
The most dangerous, but at the same time easy to diagnose (per rectum, endoscopic examination) and effectively treatable, is cancer of the final part of the gastrointestinal tract. Early detection is 95-100% curable. In Poland, however, it ranks second among cancer causes of death because it is detected too late. Cancer treatment usually consists of a combination therapy of radiation therapy followed by surgery. Depending on the stage and location of the tumor, it is excised and the intestine restored. With advanced disease or a very low localization, it may not be possible to restore it. Then an artificial anus is inserted, the so-called stoma.
Who is most affected by anal cancer? People over 40 years of age with a tendency to constipation; eating a lot of meat and low in fiber; people with a family history of cancer. Smoking, drinking alcohol and coffee also predispose to the disease. Patients infected with papillomavirus and HIV are at greater risk.
In addition to rectal cancer, other pelvic tumors can cause similar ailments in the lower GI tract. Infiltrating tumors from neighboring tissues, i.e. muscles, bones and nerves, or massive tumors that do not have to be malignant, which do not have to be malignant in the intestine, and even tumor metastases from other structures, may manifest themselves in the form of bleeding, pain, and constipation.
DISEASES OF UNCLEAR CAUSES
Spontaneous rectal pain syndromes are a group of diseases with unclear causes, difficult diagnosis and complicated treatment. It includes: levator ani syndrome occurring mainly in women, caused by contraction of the levator ani muscle; coccidia, which is traumatic pain in the coccyx, which also occurs in people with depression; paroxysmal pain in the anus – a disease of young men of unknown etiology. Due to the difficulty of finding the causes of these diseases, treatment is primarily aimed at relieving the symptoms of the disease. So the usual treatments are painkillers, massage, physical therapy and nerve blocks.
THREE QUESTIONS FOR THE PROCTOLOGIST
- How to overcome the fear and shame accompanying a visit to a proctologist?
- Talking and using the senses are the first and basic diagnostic tools. In order to define the disease well, the doctor must listen to the patient, but also see him and touch him. For doctors, these are routine tests that they perform at least several times a day, and let’s be honest, they don’t make a special impression on them. Besides, what is embarrassment compared to the quick and precise diagnosis of the problem with which the patient consulted the doctor.
- What are the first symptoms of rectal cancer?
- Unfortunately, they are usually non-specific, and often absent altogether. The patient should be alarmed and made to see a doctor, any rectal bleeding, change in the rhythm and regularity of bowel movements, diarrhea alternating with constipation, unintentional weight loss. When the tumor is large enough to narrow the intestine, we can also talk about pencil-like stools and problems with intestinal obstruction.
What are the three most important rules for the prevention of anal diseases?
A high-fiber diet, avoiding a sedentary lifestyle, and avoiding habitual constipation
Consultation Dr. Jakub Pniewski, Internal Medicine Specialist, Damian Medical Center; Warsaw
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