An anal abscess is an infected cavity filled with puss near the anus or rectum. It is almost always the result of an acute infection of a small gland just inside the anus. Bacteria or other foreign matter enters the tissue through the gland. Certain conditions such as colitis, or inflammation of the intestine can be a cause of an abscess.

Fistulas are treated with surgery and may be performed along with the abscess surgery. Fistulas often develop after an abscess is drained. Surgery usually involves opening the fistula tunnel and possibly cutting a small part of the anal sphincter muscle that helps control bowel movements. It heals from the inside out. This is typically done on an outpatient basis, although some cases may require a short stay in the hospital.

An anal fissure is a small tear or cut in the skin lining of the anus. Anal fissures may be acute, meaning recent, or chronic, meaning present for a long time or recurring frequently.

Symptoms

Anal fissures can cause pain during bowel movements that can last hours. Red blood can also appear in the toilet or stool. The pain can be so severe that some patients may try to avoid having a bowel movement. There many nerves in this area that amplifies the pain of a fissure compared to its size. The result of not wanting to have a bowel movement can lead to constipation adding to the problem.

Treatment

Most acute fissures will heal without surgery and are managed with a high fiber diet, stool softeners and plenty of fluids to avoid constipation. Medicated ointments can help ease the painful muscle spasm and promote healing of the fissure.

A chronic fissure lasting more than a month may require additional treatment. An anal manometry test may be performed to determine if sphincter pressures are high. A physical exam under anesthesia may be recommended to determine why healing is not taking place.

Constipation refers to infrequent bowel movements, but it can also refer to a decrease in the weight or volume of stool. Constipation also includes difficulty in having a bowel movement, a sense of incomplete evacuation, or the need for laxatives or other medications to maintain regularity.

Should I see a Doctor about Constipation?

If there is a persistent change in bowel habits over a few weeks, you should consult your physician. This includes a change in frequency or size of stool or difficulty in evacuating.

Crohn’s disease is a chronic inflammatory process that primarily affects the intestinal tract. It can appear anywhere along the intestinal tract from the mouth to the anus but is found mostly at the end of the small intestine or the large intestine. Crohn’s is a chronic condition that may persist for periods over a lifetime. Long remissions are possible but are no guarantee that the condition will not reappear. This reoccurring pattern is unpredictable. Crohn’s disease and ulcerative colitis are both considered inflammatory bowel diseases.

Treatment

Crohn’s disease is treated by various levels of drug treatment depending on the severity of the case. Starting at a mild case, some recommend fish oil. This is also recommended when the side effects of other medications are too strong. Mild and moderate cases are oral medications called aminosalicylates, which help relieve inflammation and help with remission. The more serious cases are treated with corticosteroids such as Prednisone. Surgery is ultimately recommended in a majority of cases.

It is important as part of the regime to be sure to supplement with certain nutrients. These include B12, folic acid, Vitamin D, iron, magnesium and potassium. All of these important nutrients are commonly lacking in Crohn’s sufferers. Finally, Crohn’s symptoms can be improved by a proper diet and exercise program. Since cases vary in its location in the body and its severity, it is important to discuss all these issues with your colon and rectal specialist.

Diverticulosis is a very common condition of the colon where pockets appear in the colon wall. In most cases, there are no symptoms. Diverticulosis describes the existence of these pockets and diverticulitis describes the inflammation or complications of these pockets. This condition afflicts about one half of all Americans by age 60 and nearly all by age 80.

Treatment

Adding fiber to the diet is the simplest treatment as well as reducing certain foods can reduce the pressure on the colon. This can result in a decreased risk of complications with diverticular disease. Mild diverticulitis may be managed with antibiotics, dietary management, or stool softeners. In more severe cases the patient is hospitalized and given intravenous antibiotics and dietary restraints. In cases where the patient has recurring attacks or the other treatments do not work, surgery is required. Surgery removes the part of the colon that is diseased. Typically the colon is reattached (anastomosed) to the rectum. Complete recovery is typical in a few weeks. Emergency cases occasionally require a temporary colostomy bag.

Consult your doctor if you begin to experience any abdominal pain or other symptoms in order to avoid more serious complications.

Irritable Bowel Syndrome – referred to as IBS – is a common disorder that may affect up to one-third of all Americans at some point in their lives. It is also called nervous colon, spastic colon, spastic bowel, mucous colitis or spastic colitis. IBS is not a disease, but rather a condition or pattern of symptoms, primarily consisting of pain and bloating. It is not life-threatening.

Symptoms

Symptoms may include constipation, diarrhea, gas, or cramps. Irritable Bowel Syndrome symptoms may come and go or change over time. Constipation and diarrhea may alternate. Rectal bleeding is NOT a symptom of IBS and should be evaluated immediately by your physician.

Treatment

Diet can contribute to IBS. Therefore increasing “roughage” — fruits, whole grains, and vegetables — and increasing water intake can help soften stools or absorb excess water to prevent diarrhea. Understanding that IBS is not serious or life-threatening can reduce the stress level. There are medications your physician may prescribe that act directly on the intestinal muscles to help contractions return to normal.

Prutitas ani is simply Latin for anal itching and occurs mostly at night or after a bowel movement.

Causes

Generally moist skin in the anal area combined with fecal matter retained in the anal folds cause itching. Improper cleaning of the area is the core cause. Excessive sweating or tight-fitting clothing can also cause pruritas ani. Certain foods can aggravate the situation including alcohol, citrus drinks, caffeine, spicy food, chocolate, nuts and popcorn.

Treatment

Generally this condition can be treated at home with gentle cleansing with water and a washcloth and corn starch if moist or over-the-counter petroleum jelly if dry. A hydrocortisone product often provides satisfactory results. Avoid soaps and do not scratch the area. Wear loose-fitting clothes and eliminate irritant foods. If the condition persists, call your physician and make an appointment.

Ulcerative colitis is an inflammation of the lining of the large bowel. Among the possible symptoms are diarrhea, rectal bleeding, cramps, weight loss or fever. In cases of extensive ulcerative colitis over a long period of time (years), there is an increased risk of developing cancer in the large bowel.

Treatment

In the early stages, drug treatment is utilized with either antibiotics or anti-inflammatory steroidal drugs such as Prednisone. With this disease drugs are typically prescribed for the long term. However, prednisone has significant side effects and is usually used for short periods of time. At some point it may be necessary to hospitalize a patient. Surgery is called for if symptoms become life threatening, such as massive bleeding, perforation or significant infection. This is used only if other medical treatment fails to bring relief or if signs of cancer appear.

Surgical Options

A proctocolectomy removes the entire large intestine, rectum and anus, which are replaced by bringing the remaining bowel through the intestine wall. A collection device is placed on the outside of the body. Internal collection is also possible, which requires drainage three or four times a day. This method eliminates cancer risk and risk of recurrent persistent colitis, but internal leakage is a possibility, which would require an additional operation.

An ileoanal procedure, which leaves the anus in place and connects the remaining small intestine to the anus. It is refashioned into a small pouch to perform the large bowel function.