Anal Symptoms That Matter!
Q. I have bleeding when I pass stool. Is it something to worry?
A. It depends. If it’s been for years and is painless and there has been no change in the bowel motions recently, then it’s likely it’s the piles (or haemorrhoids in scientific jargon).
However if the bleed is a recent phenomenon, is associated with pain and change in bowel motion, then it may be an indication of a sinister cause such as a tumour. One should get in touch with a gastro physician or a Gastrosurgeon for complete assessment.
Piles can nowadays be treated by a stapler technique that is entirely painless and is wound free. For patients who are morbidly scared of anal surgery, this is great news!
Q. I have a discharging perianal wound that gives recurrent trouble. However I am fine in the intervening period. Do I still need to see a doctor?
A. Yes. This is most likely a anal fistula. Although it almost never is due to a tumour (a notion that the patient misconceives commonly) the main reason for treatment is because the fistula turns increasingly complex with time. The recurrent infection makes it develop branches and side branches like a tree. These complex fistula may then become more difficult to treat often leading to failures. Hence the aphorism – a stitch in time saves nine- may be most appropriate for anal fistula.
Q. I have pain when I pass stool. I am managing myself somehow but some days it’s worse. I am scared to see a doctor since I think he will advise surgery and I am petrified with the thought of surgery.
A. This sentiment of fear is very common in anal diseases. One should realise that pain during passage of stool should not be taken lightly. They may be a symptom of a tumor or a colitis (inflammatory bowel disease) that of course will benefit from early diagnosis and treatment. Secondly certain diseases that cause anal pain such as anal fissure are simple to treat either medically or surgically.
The fear of anal surgery is something that needs to be addressed by public awareness. Let me reassure that anal surgery has come of age. It’s nowadays a very comfortable procedure. Most procedures can now be performed inflicting minimal pain and wound. The postoperative dressings are rarely required. Most patients are able to get back to work within a week.
Q. I have been diagnosed with rectal cancer. I don’t want a colostomy ( a bag in the tummy for passing stool). Is there a way to keep my normal anus to pass stool?
A. A rectal cancer is nowadays treated first with radiotherapy and chemotherapy. More often than not it shrinks the tumour. If after this therapy the rectal cancer is at least 5 cm away from the point where the anus starts, then the patient may get away without a bag in the tummy (colostomy). This procedure is particularly facilitated with use of technology such as circular staplers snd laparoscopy.
Q. My rectum tends to come out when I strain. Sometimes I cannot control my stool passage. How can I get cure from this embarrassing problem?
A. This is most likely a rectal prolapse. This is usually seen in women with some perineal injury or weakness during childbirth. The treatment of this situation can be done through a laparoscopic technique whereby the rectum is fixed back to the bone behind (called sacrum). Post surgery the patient is trained to perform certain pelvic floor exercises to get the strength back.
