What are hemorrhoids?
Hemorrhoids are swollen veins in the mucocutaneous tissue of the anus.
The mucosa and underlying hemorrhoidal tissue become swollen and may protrude from the anus. Early stage hemorrhoids do not protude or bleed, but as time passes, they may prolapse and protrude from the anus.
☞ Hermorrhoids are commonly caused by straining during bowel movements.
Symptoms of hemorrhoids vary depending if they are found externally or internally. Bleeding associated with internal hemorrhoids is usually bright. Prolapse of internal hemorrhoids into the anus with associated pain is common.
Non-surgical treatment is possible for stage 1 and stage 2 hemorrhoids, but surgery is recommended for stage 3 and stage 4 hemorrhoids.
What is an anal fistula?
An anorectal abscess is a collection of pus found near the anus that is released from infected glands just inside the anus. An anal fistula is the tunnel that forms under the skin and connects a previously clogged infected anal gland in which the abscess arose to an opening on the skin around the anus.
Anal glands at the dentate line can become infected due reduced immune resistance caused by overworki or diarrhea. This leads to an anorectal abscess and anal fistula.
An anoreatal abscess can be diagnosed easily since the area around the anus is red and swollen with an accompanying fever.
Pus from the opening near the anus and the infected tunnel connecting the skin and the pus can be felt. Throbbing pain and a discharge of pus or gas or blood may occur during bowel movement.
Surgery is usually necessary to treat an anorectal abscess and anal fistula.
The treatment of an anal abscess involves surgery to open and drain the abscess. Any delay in surgical drainage of the abscess leads to an increased size of the abscess and damage to the tissues around the anus. Depending on the need for simple or complex treatment, the surgical approach is different. A simple fistula is treated by removing the fistula tract, It does not limit the function of any organ since only a small portion of the sphincter muscle is cut out. This is the most common procedure to prevent the recurrence of an anal fistula. A more complex fistula is a bit more complicated and is performed in 2 steps. It allows closure of the internal fistular opening within the anal canal and the healing of the fistula without cutting the anal sphincter.
What is an anal fissure?
An anal fissure is a cut or tear in the internal anal sphincter, It is usually a sign that the anal sphincter is fibrotic and thin. It may cause painful bowel movements and bleeding.
Fissures may be caused by passing large, hard stools, or by having diarrhea for a long time.
When the skin of the anus at the dentate line, which has a high concentration of sensory nerves, is torn, it results in painful bowel movements and bleeding. When an anal fissure is present, the internal sphincter can go into spasm, resulting in prolonged pain after bowel movements.
The most common treatment of an acute anal fissure consists of preventing the opening of the anus from becoming too small by ensuring the stool bulkier and more well formed, and by avoiding a repeat injury in the same spot.
Chronic anal fissure needs partial internal sphincterotomy to find a fundamental solution since changes in internal anal sphincter has been made already.