Colorectal Disease

This is characterized by a small tear in the lining or muscle of the anus. They typically occur as the result of passing large or hard stools, or from severe diarrhea.
Symptoms include:

• Pain during or after a bowel movement
• Bleeding during or after a bowel movement
• A tearing sensation with bowel movements

Diagnosis

There are certain risk factors associated with anal fissures including childbirth, constipation, and Crohn’s disease. Typically, a physical exam is all that is needed to diagnose an anal fissure.

Treatment

With proper care, anal fissures heal within a few weeks. Nonsurgical treatments include topical creams, warm water soaks and avoidance of straining In the event that an anal fissure is chronic and does not heal, your surgeon may recommend botox injections or a lateral internal sphincterotomy.

Anal warts, also known as “condyloma acuminata,” form in and around the anus. They often first appear as small growths, but over time can become larger, sometimes having a cauliflower like appearance. They are often asymptomatic, but can cause pain in some patients.

Diagnosis

Anal warts are caused by human papilloma virus (HPV), which is a common sexually transmitted disease. Anal warts can be spread by any contact from an infected partner, including secretions or skin-to-skin contact. A physical examination of the affected area is used to diagnose anal warts. Your physician may use a small instrument (about the size of a finger) to inspect the anal canal for additional warts.

Treatment

Anal warts can sometimes be treated non-surgically with topical medications such as podophyllin, trichloroacetic acid, and bichloroacetic acid. Warts can also be frozen with liquid nitrogen.

Surgery may be required to treat anal warts. The number and location of the warts determines whether a local or general anesthetic must be used. Anal warts can sometimes be removed in a procedure room at the Surgical Institute of the Palm Beaches. More severe cases may need to be removed in the operating room.

If warts are extensive, multiple surgeries may be required. About half of patients will develop warts again following removal, requiring additional treatment or surgery.

Crohn’s disease is an incurable inflammatory disorder of the gastrointestinal system. The innermost lining of the gastrointestinal tract becomes inflamed, resulting in a range of symptoms and disease. Patients with Crohn’s disease are more likely to develop a fistula, which is a small opening that forms between the bowel and another part of the body.

Diagnosis

Symptoms of Crohn’s Disease include:

• Abdominal cramping
• Abdominal pain
• Ongoing diarrhea
• Chronic constipation
• Bleeding with bowel movements
• Fever
• Extreme tiredness
• Weight loss
• Drainage from the skin around the anus
• Recurring abscesses (infections) and fistula around the anus
• Anal fissures

Crohn’s disease is diagnosed through both a physical exam and medical history.

Treatment

Anti-inflammatory medications and antibiotics are the first option, unless emergency surgery is needed. Surgery is considered when symptoms cannot be controlled through medications. When untreated, Crohn’s disease can become life threatening, resulting in a hole or blockage in the bowel. If a portion of the bowel becomes too scarred or narrow to function properly, your surgeon may remove the diseased portion and reconnect the remaining bowel if possible. If this is not possible, an ostomy may be performed, creating a surgical opening in the abdominal wall for the evacuation of waste.

In some patients, the disease may result in an anorectal abscess. In these cases, surgery will be performed to drain the abscess, allowing the infection the clear up.

Small pouches called diverticula can form in the lining of your digestive system. Diverticulitis occurs when one or more of these pouches becomes inflamed or infected. Symptoms of diverticulitis include:

• Nausea
• Fever
• Severe Abdominal Pain
• Bloody Stool
• Constipation

A mild case of diverticulitis can be treated with antibiotics, rest, and dietary changes. Adopting a liquid diet for a few days can help your bowels heal before introducing solid foods again. Making dietary lifestyle changes to include 25-35 grams of fiber per day for the long-term can further help mitigate this issue.

In more severe cases of diverticulitis or when diverticulitis becomes persistent, surgery may be recommended. Your doctor will discuss all of your options with you and determine the best approach to treat your particular case.

The loss of bowel control that causes the unexpected passing of stool. It can be the result of an injury, disease, as well as general aging and muscle weakness.

Diagnosis

In addition to a physical exam, you will be asked about your condition as well as your medical history. From there, your doctor will order various tests in order to determine the precise cause of the incontinence.

Treatment

Treatment varies depending on the cause. Dietary changes and implementing certain exercises can help. Surgical options can include sphincter reconstruction and/or implantation of a peripheral nerve stimulator.

These are swollen blood vessels that form in your anus and lower rectum. There are both external and internal hemorrhoids. The primary symptoms of hemorrhoids are:

• Discomfort
• Irritation
• Itching
• Swelling
• Bleeding

Diagnosis

To properly diagnose hemorrhoids, it requires a physical exam. Additional tests might be run to discern if hemorrhoids are the cause of anal bleeding, or if there is another cause for the bleeding.

Treatment

There are several effective treatment options available. Certain lifestyle changes can also make a difference. In severe cases, surgery might be recommended.