Anorectal Diseases

Anorectal disease pertains to those illnesses located in the anal and rectal portions of the large intestine.

Anorectal disease refers to illnesses of the anus and/or rectum. The most common ailments include hemorrhoids, anal fissures, anorectal abscesses, and anal fistulas.

Hemorrhoids: Hemorrhoids are large blood vessels similar to varicose veins located around the anus and lower rectum. Some common causes of hemorrhoids include aging, chronic constipation, and pregnancy. Symptoms include itching, inflammation, and pain. Read more about hemmerhoids.

Anal Fissures: Anal fissures are small tears in the lining of the anus. Some causes of anal fissures include hard, dry bowel movements, diarrhea, and inflammation in the anorectal area. Symptoms include pain, bleeding, and itching.

Anorectal Abscess: An anorectal abscess is a pus-filled infection around the area of the anus or rectum. Anal abscesses occur when bacteria or fecal matter enters the tissue outside the anus through infected anal glands. Symptoms include pain, anal skin irritation, pus drainage, fever, and swelling. Having an inflammatory bowel disease, such as Crohn’s disease or colitis, increases the chance of getting an anorectal abscess.

Anal Fistula: About 50 percent of the time, an anorectal abscess develops into a fistula, which is an abnormal tunnel that connects infected glands inside the anus to the opening of the skin around the anus. Symptoms include pain, anal skin irritation, pus drainage, fever, and swelling.

There are a number of causes of anorectal diseases depending on which disease the patient has. Some of the most common causes include:

  • Chronic constipation
  • Chronic or prolonged diarrhea
  • Anal sex or anal stretching
  • Straining when having a bowel movement

Depending on underlying medical conditions, anorectal disease may be caused by a variety of factors.

Colorectal surgeons may use the following tools to confirm or rule out the presence of an anorectal disorder:

  • Physical exam and history
  • Digital rectal exam
  • Anoscopy: A diagnostic procedure in which a small, tubular instrument with a light attached is used to view the last few inches of the rectum and anal canal.
  • Flexible sigmoidoscopy (flex sig): A diagnostic procedure in which a small, tubular instrument with a video camera is used to view the last few feet of the large intestine.
  • Colonoscopy: This procedure allows physicians to view the entirety of the large intestine. A colonoscopy is similar to a flex sig, but usually requires a more thorough bowel prep and is performed under moderate sedation. Read more about colonoscopy.
  • Biopsy: Removal of a small piece of tissue for examination.
  • Ultrasound or MRI: Noninvasive imaging tests that show the structure and function of the anal canal, sphincter muscles and rectum.

The goal of treatment for all anorectal diseases is to reduce pressure on the anal canal while making stools soft in order to relieve discomfort and pain during a bowel movement. As in anal fissures, the prevention of constipation is a must.

Conservative treatment may include stool softeners, hydrocortisone containing suppositories, foams and creams. Medicated ointments may help reduce the tears and bleeding along the outside of the rectum.

In the most severe cases of anorectal disease, surgery may be the only option to repair the tear or correct other problems that are contributing to the symptoms. When conservative treatments fail, or internal scarring has developed, surgery may be the only choice for correcting the problem.