Last updated date: 12-Aug-2023
Originally Written in English
The anus is the intestinal system section that goes through the muscular canal of the anal sphincter and the pelvis. It’s usually the last rift through which fecal matter passes as it gets out of the body. The length of the anus in adults is about four to five centimeters long. The lower half of the anal can consist of sensitive nerve endings. It also has blood vessels beneath the lining and several small anal glands in the central part.
As with any other body organ, the anus is also susceptible to a wide range of diseases (anal diseases). Anal disease is usually common and can affect people of any age. Although talking about such disorders with the doctor can be embarrassing, it’s highly essential. This is especially if it’s associated with bleeding and pain.
Types of Anal Diseases
The most common types of anal diseases that cause irritation and pain in the anus include;
- Anal fissure
An anal fissure can also be referred to as an anorectal fissure. It’s a longitudinal tear or split that occurs in the anoderm, the lower anal canal's lining. The majority of anal fissures arise when a huge, hard stool excessively stretches the anal opening, tearing the fragile anoderm.
Anal fissures form less often as a result of inflammatory bowel disease, prolonged chronic diarrhea, or sexually transmitted illness that affects the anorectal region. Acute or short-term anal fissures are normally shallow and superficial. Persistent or long-term anal fissures can expand deeper into the anoderm, hence exposing the underlying muscle surface.
- Anal fistula
An anal fistula refers to an irregular small tunnel-like pathway left behind from an old anal abscess as it drains. It attaches the middle part of the anal canal or the anal gland to the skin's surface. An anal fistula can form at least half of the period after the anal abscess drains. It can either drain naturally or through pierce by the healthcare provider.
In other cases, the fistula opening at the surface of the skin causes continuous discharges of bloody fluid or pus. At times, the fistula opening temporarily seals, making the initial anal abscess resurface as a sore pocket of pus.
- Anal abscess
An anal abscess is characterized by a sore swelling buildup of fluid close to the anus. In most cases, the anal abscesses are not associated with any health issues. Furthermore, they develop on their own due to unknown causes. They begin in a tiny anal gland and gradually enlarges to form an infection site beneath the skin.
Individuals aging 20 to 40 account for more than half of the anal abscesses, with men being affected more frequently, unlike women. The majority of anal abscesses occur near the anus entrance. However, they may also develop higher or deeper in the anal canal, near the lower pelvic organs or lower colon.
Hemorrhoids are not usually painful. Nonetheless, the blood vessels in tiny hemorrhoids at the anal orifice edge may clot off at times. This condition is known as thrombosis. Diarrhea or duration of constipation can trigger thrombosis. When this occurs, the anterior hemorrhoid swells, hardens, becomes sore, and is sometimes associated with blood discharge.
Symptoms of Anal Diseases
All the common types of anal disorders are usually associated with anal pain and discomfort. However, other varying symptoms can occur depending on the anal issue. If you have the condition, then you are likely to experience one or more of these anal disease symptoms;
- Anal pain that is usually portrayed as searing, burning, or sharp and is typically caused by a bowel movement
- Minor rectal bleeding characterized by a small amount of bright red blood during a bowel movement or on the toilet paper
- A rigid, tender mass or swelling that occurs inside or around the rectal region can grow large
- Chills, fever, and a general sick feeling occur from time to time
- Acute pain near the anus concentrated on a region where the old anal abscess has been spontaneously drained. It can also be where the surgeon has surgically opened.
- Consistent anal drainage of pus, blood, or foul smelly mucus from the anus
- The symptoms of a recurring anal abscess can occur if the fistula's external opening gets blocked and the initial abscesses reactivate.
- A rigid and sometimes painful swelling on the anal orifice
- If hemorrhoid's surface deteriorates, there might be a discharge of blood
Diagnosing Anal Diseases
If the doctor notices that you have symptoms related to anal disease, they will inquire about the medical history. They can also ask about your lifestyle to enable them to determine the underlying cause of the condition.
Based on the associated symptoms, they can further inquire about the following;
- The bowel habits, more so if you have a history of constipation
- The previous medical records, such as the history of the anal bleeding, sexually transmitted disease, inflammatory bowel disorder, and cancer radiation therapy.
- The use of over-the-counter or prescribed drugs that might pose the risk of severe bleeding.
- If you engage in anal intercourse or have a previous anal trauma history
The next step involves a physical examination of the abdomen to check for visible signs and symptoms. The doctor will also perform an external analysis of the anal region, including a finger or digital rectal examination.
Furthermore, the doctor will also conduct other diagnostic procedures, including;
Anoscopy: This involves the insertion of an anoscope, tubular equipment into the anus to enable the doctor to view the anus and the rectum.
Flexible sigmoidoscopy: This involves implanting a small flexible tube containing a minute video camera into the bottom of the colon. If you are under the age of 50 and don’t have risk factors for bowel disorders or colon cancer, you might be eligible for this exam.
Colonoscopy: To check the whole colon, the doctor will put a flexible tubal device into the rectum. The procedure is suitable if you are over 50 years and have risk factors for bowel cancer. It’s also recommended if you have other symptoms such as diarrhea or stomach pain.
Treatment Options for Anal Diseases
Before opting for any form of anal disease treatment, it’s essential first to undergo a thorough diagnosis. Depending on the underlying condition, the treatment can or might not require a surgical procedure. In case surgery is needed, the doctor can use whatever kind of anesthesia is suitable. This is to protect you from experiencing any discomfort within the sensitive region.
If you have an acute fissure, the doctor can suggest following the constipation relief advice. They can also recommend applying a medical ointment to the area. Soaking the anus in warm water for about 10 to 15 minutes per day (sitz bath) can be helpful. If you have a severe fissure, surgery will cure the problem in more than 90 percent of cases.
The doctor will open or pierce an anal abscess to remove the pus. This is known as the incision and drainage technique. It is normally performed as an outpatient operation. This is particularly for people who are young and in good health condition, and the abscess is near the anal opening.
The most common treatment is surgery to help unroof the fistula tract, a fistulotomy procedure. The surgeon will open up the affected canal and scratch out any traces of the former anal abscess. After that, the wound will remain open so that it can regenerate from the bottom up. In case the fistula is related to Crohn's disease, anti-inflammatory drugs paired with an antibiotic are used to cure Crohn's disease.
Normally, this will go away gradually with time. Taking a fiber supplement to soften the stool, as well as daily warm water soaks, will speed up the process. If the clotted hemorrhoid is exceptionally painful and sore, the doctor can perform a limited procedure. In most cases, it’s done under local anesthesia and involves the extraction of the clotted hemorrhoid.
Preventing Anal Disease
The best way to prevent or avoid anal fissures is to avoid constant constipation. Soften the stool by steadily increasing your fiber intake and taking 6 to 8 glasses of water a day. Fiber supplement powders that are commercially available perform well.
While it's not always easy to avoid other forms of anal diseases, you can reduce the chance by:
- Cleaning the anal region with soft techniques
- Ensuring that the anal area remains dry always. This is by constantly changing underwear and applying powder to trap moisture
- If you indulge in anal sex, do use a condom.
- Avoid putting something foreign into the rectum.
Anal diseases are usually common. Nearly every person experiences anal bleeding, itching, and pain at a certain period in life. Most of these issues are minor and can disappear on their own with time or through home remedies. However, some chronic and further medical attention is necessary to diagnose and determine the underlying cause. This also helps develop an effective treatment plan.
For the best treatment of such anal disorders, you can consider the CloudHospital medical platform. Here, you will receive comprehensive treatment and care from professional experts. They will also give you significant measures to prevent future recurrence.