Proctology
Haemorrhoids
Haemorrhoids are a small network of blood vessels arising in the anal canal. Internal haemorrhoids can enlarge, bleed, and prolapse. As they prolapse, external skin can become prominent or form skin tags. Haemorrhoids are not typically painful unless they become ‘stuck outside’.
Symptoms include, bleeding, lumps, difficulty with hygiene, discomfort, or sudden and painful prolapse and thrombosis.
Treatment
Injection of internal haemorrhoids
Banding of internal haemorrhoids
Haemorrhoidecomy
Perianal conditions
Anal skin tags
puritisani
Anal fistula
Anal fistula is an abnormal communication between the skin close to the anal opening and the inside of the lower bowel (anus or rectum). This is a late complication of perianal abscess.
Causes
- Most result from an abscess or infection around the anal canal. The infection is thought to start due to a blocked and infected gland in the wall of the anus. Around 30% of perianal abscesses will proceed to form an anal fistula.
- Other rarer causes include inflammatory bowel disease such as Crohn’s disease, foreign body, trauma or malignancy
Presentation
- Painful swelling around the anal skin with or without fever/sweats
- Recurring pus discharging from a wound in the skin around the anus
Treatment
- Anal Fistula always requires an operation to treat, in some cases it may require multiple operations to completely remedy the fistula.
- The aim of surgery is to control infection, protect the muscle of the anal sphincter and thereby prevent fecal incontinence and ultimately heal the fistula.
Many operations exist to treat anal fistula. The operation and number of procedures you will require to completely treat your fistula is specific to the anatomy and complexity of the fistula tract and will be discussed with you by the surgeon. Operations include the following (which are performed with examination under general anaesthesia in hospital) but are not limited to:
Fistulotomy – Lay open of the fistula.
The simplest of the treatment which is usually a single procedure that will lead to healing of the fistula without the need for further operation.
Placement of a Seton Drain
A procedure designed to control the chronic infection and inflammation of the fistula and inhibit the external skin opening from healing over and causing further abscess and discharge. The fistula tract usually reduces in size and length with a seton drain and can over time result in the fistula being appropriate for fistulotomy at a later date.
LIFT procedure, use of a closure device and mucosal Advancement flaps.
Such procedures are used less commonly and if required, the specific details of the operation will be discussed with you by your surgeon.
Anal fissure
