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What is proctology?

What type of illnesses call under proctology?

What are hemorrhoids?

What causes hemorrhoids?

What are the symptoms of hemorrhoids?

How common are hemorrhoids?

How are hemorrhoids diagnosed?

What is the treatment for hemorrhoids?

How are hemorrhoids prevented?

What is an anal fissure?

What are the causes and risk factors of anal fissure?

What are the symptoms of anal fissures?

How is it diagnosed?

How is it treated?

How can I prevent it?

Where can I find more information on proctologic disorders?

Where can I buy a home test kit for prostate related disorders?

What is proctology? (top)

Proctology is a field in medicine dealing with diseases and disorders of the rectum, anus, colon and pelvic floor.

What type of illnesses call under proctology? (top)

• Varicosities or swelling, and inflammation of veins in the rectum and anus (hemorrhoids)

• Unnatural cracks or tears in the anus (anal fissures)

• Abnormal connections or passageways between the rectum or other anorectal area to the skin surface (Fistulas)

• Severe constipation conditions

• Fecal incontinence

• Protrusion of the walls of the rectum through the anus (rectal prolapse)

• Birth defects such as the imperforate anus

• Cancer of the colon and rectum (colorectal cancer)

• Anal cancer (rare)

• Any injuries to the anus

What are hemorrhoids? (top)

The term hemorrhoids refers to a condition in which the veins around the anus or lower rectum are swollen and inflamed.

What causes hemorrhoids? (top)

Hemorrhoids may result from straining to move stool. Other contributing factors include pregnancy, aging, chronic constipation or diarrhea, and anal intercourse.

What are the symptoms of hemorrhoids? (top)

Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.

Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid.

In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

How common are hemorrhoids? (top)

Hemorrhoids are very common in both men and women. About half of the population have hemorrhoids by age 50. Hemorrhoids are also common among pregnant women. The pressure of the fetus in the abdomen, as well as hormonal changes, cause the hemorrhoidal vessels to enlarge. These vessels are also placed under severe pressure during childbirth. For most women, however, hemorrhoids caused by pregnancy are a temporary problem.

How are hemorrhoids diagnosed? (top)

A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires an exam with an endoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, useful for more completely examining the entire rectum.

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

What is the treatment for hemorrhoids? (top)

Medical treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include:

• Tub baths several times a day in plain, warm water for about 10 minutes

• Application of a hemorrhoid cream or suppository to the affected area for a limited time

Preventing the recurrence of hemorrhoids will require relieving the pressure and straining of constipation. Doctors will often recommend increasing fiber and fluids in the diet. Eating the right amount of fiber and drinking six to eight glasses of fluid (not alcohol) result in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding.

Good sources of fiber are fruits, vegetables, and whole grains. In addition, doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).

In some cases, hemorrhoids must be treated endoscopically or surgically. These methods are used to shrink and destroy the hemorrhoidal tissue. The doctor will perform the procedure during an office or hospital visit.

A number of methods may be used to remove or reduce the size of internal hemorrhoids. These techniques include:

• Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.

• Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.

• Infrared coagulation. A special device is used to burn hemorrhoidal tissue.

• Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.

How are hemorrhoids prevented? (top)

The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs. Exercise, including walking, and increased fiber in the diet help reduce constipation and straining by producing stools that are softer and easier to pass.

What is an anal fissure? (top)

An anal fissure is a small split or tear in the anal mucosa that may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet tissue following a bowel movement

What are the causes and risk factors of anal fissure? (top)

Anal fissures are extremely common in young infants but may occur at any age. Studies suggest 80% of infants will have had an anal fissure by the end of the first year. Most fissures heal on their own and do not require treatment, aside from good diaper hygiene. However, some fissures may require medical treatment

In adults, fissures may be caused by constipation, the passing of large, hard stools, or by prolonged diarrhea. In older adults, anal fissures may be caused by decreased blood flow to the area.

What are the symptoms of anal fissures? (top)

• Pain while having a bowel movement

• Blood on the surface of stool (not mixed in with stool)

• Blood on toilet tissue or wipes

• A crack in the skin that is visible when the anus is stretched slightly (the fissure is almost always in the midline)

• Constipation, often with painful bowel movements

How is it diagnosed? (top)

Anal fissure is diagnosed by an inspection of the rectum and a physical exam of the rectal mucosa.

How is it treated? (top)

• Stool softeners

• Dietary adjustment (addition of bulk -- substances that absorb water while in the intestinal tract)

• Cleansing more gently

• Petroleum jelly

• Sitz bath

• Anesthetic ointment, if pain interferes with normal bowel movement

• Topical muscle relaxants

These measures generally heal more than 90% of anal fissures.

For fissures that do not heal with these home treatments, injection of botulinum toxin (Botox) into the anal sphincter may be used to temporarily paralyze the anal sphincter muscle and promote healing. Another option for non-healing fissures is a minor surgical procedure to relax the sphincter.

How can I prevent it? (top)

To prevent anal fissures in infants, be sure to change diapers frequently.

To prevent fissures at any age:

• Keep the anal area dry

• Wipe with soft materials or a moistened cloth or cotton pad

• Promptly treat any constipation or diarrhea

• Avoid irritating the rectum

Where can I find more information on proctologic disorders? (top)

For more information on prostate and prostate cancer, click here

For more information on hemorrhoids, click here

For more information on anal and rectal issues, click here

For more information on constipation conditions, click here

Click here to buy home test kits for
prostate related disorders

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