ANAL DISEASE
The anal disease is a local disease, but it can also be a symptom of several other conditions. You may be embarrassed to talk about your anal troubles; however, it is essential to let your doctor know in detail so that there is the right treatment for each particular problem.
ANAL ANATOMY
The anus is the part of the intestinal tract that passes through the muscular tube of the pelvis and the anal sphincter. This is the official hole through which stool passes out of the body. In an adult, the anus is 4-5 cm long. The lower half of the anal canal has sensory nerve endings. There are blood vessels under the mucosa, and in its middle part, there are many anal glands.
COMMON ANAL DISEASE
Anal fissure
An anal fissure is a tear in the lining of the lower part of the anal canal. Most anal fissures occur after passing large, hard stools.
Less common causes of anal fissures are persistent diarrhea, colitis, or sexually transmitted diseases involving the anorectal area. Acute anal fissures are usually shallow, but chronic anal fissures may extend deeper through the anoderm to expose the surface of the underlying muscle.
Anal abscess
An anal abscess is a painful, swollen mass that contains pus near the anus. Most anal abscesses are unrelated to other health problems and arise spontaneously for unknown reasons. An abscess starts from a small gland in the anus, which enlarges to create an infection site under the skin.
Anus abscess usually occurs in young people between the ages of 20 and 40, and men are affected more often than women. Most anal abscesses are located near the anus but can occur deeper or higher in the anal canal, near the rectum, or organs in the pelvis.
Anal fistula
An anal fissure is an abnormally narrow tunnel caused by an old anal abscess after pus has been drained. It connects the middle part of the anal canal (at the anal glands) to the skin's surface.
After the anal abscess has drained (spontaneous or lanced by a physician), at least 50% of an anal fistula will develop. Sometimes the opening of the fistula at the skin surface constantly discharges pus or bloody fluid. In some cases, the fistula closes temporarily, causing the old anal abscess to flare back to painful pus.
Hemorrhoids
Hemorrhoids are swollen or dilated blood vessels (veins) in the anal canal, and symptoms can develop. Many people have hemorrhoids but have no symptoms. There are two types of hemorrhoids: Internal hemorrhoids are located above the dentate line, and external hemorrhoids are located below the dentate line.
Hemorrhoids can develop as a result of repeated pushes with a bowel movement, sometimes as a result of long-term constipation. Hemorrhoids are also commonly seen in any condition that leads to increased intra-abdominal pressure, for example, during pregnancy and heavy lifting.
Anal warts
Anal warts or genital warts are a disease that affects the area around and inside the anus. It can also affect the skin of the genital area. At first, it appears as pin-like spots and can grow quite large and cover the entire anal area.
Usually, genital warts do not cause pain or discomfort, and the patient may not be aware of the disease. Some patients experience itching, bleeding, mucus discharge, and/or a lump in the anal area.
Anal cancer
Anal cancer is an uncommon cancer of the anal canal. Anal cancer can cause signs and symptoms such as rectal bleeding and anal pain.
Feb 19, 2021
HUNG M. DO, MD, Ph.D