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Anal Diseases: The Uncomfortable Truths You Should Not Avoid

16 Aug 2023

Anal diseases are more common than you think, yet they are seldom talked about. In Singapore, most adults aged 30 years and above would have experienced anal diseases in their lives. Anal diseases, also known as anorectal disorders, refer to conditions that develop in the rectum and the anal canal.

In a majority of cases, anal disease is caused by bowel disorders, leading to damage to the rectal wall lining or, in more severe cases, pointing to medical conditions that need immediate treatment.

All in all, an individual suffering from anal disease may experience the following symptoms:

Rectal or anal pain

Rectal bleeding

Itch in the anal region

Bloody stools

Swollen anal region

Presence of discharge with passing of stools

In severe cases, anal disease may lead to the development of sepsis, which is a life-threatening blood poisoning.

In this article, we will explore some of the common anal diseases that we see patients coming in for.

1. Haemorrhoids

Haemorrhoids are very common, affecting over 10 million all around the world annually. Also known as piles, they essentially are swollen veins located in the anal canal and lower rectum that may be external or internal, depending on their relationship to the dentate line.

External haemorrhoids occur from the inferior haemorrhoidal plexus, which contains several pain receptors. Hence, they typically result in pain. Internal haemorrhoids, on the other hand, occur from the superior haemorrhoidal plexus and do not have any pain receptors. As such, they are painless. However, they do result in bleeding.

Haemorrhoid can be a result of chronic constipation or over-straining of the bowel muscles. Common symptoms are faecal leakage, bloody stools, and painful bowel movements. Most haemorrhoid cases will go away on their own. However, in more severe cases, haemorrhoidectomy or piles ligation is required to treat the condition.

2. Anal abscesses

Also known as perianal abscesses, anal abscesses are small anal glands that have become infected, resulting in the accumulation of pus in the anus, causing severe discomfort and pain. The condition can sometimes develop further into a more chronic condition called anal fistula.

Some common symptoms of anal abscess and fistula are constant throbbing pain in the anus, swelling, painful bowel movements, pus discharge, rectal bleeding, and difficulties in urinating. The difference between anal fistula and anal abscess is that fistulae are irregularly painful, while abscess comes in constant pain.

An anal abscess can be associated with IBD, such as ulcerative colitis, Crohn’s disease or even colorectal cancer. As such, a gastro cancer screening may be conducted to ensure cancer is not the primary cause. It is also linked to a weakened immune system that can be caused by conditions such as AIDS or HIV. It can also happen as a result of recurring diarrhoea, medications, anal sex, and constipation.

In order to treat anal abscesses, an incision and drainage is required. By doing so, you are able to prevent the spread and recurrence of the abscess. Also, it prevents the development of anal fistula, which requires a surgical procedure to treat it.

3. Anal fissures

Also known as anorectal fissures, anal fissures are tears that occur from the anoderm distal to the dentate line. They can be acute or chronic, depending on how long they have been present. If the tear is present for less than three months and can be treated with proper local management, it is an acute fissure. However, if it occurs for more than eight weeks and happens due to poor blood flow and scarring, then it is a chronic anal fissure. With chronic anal fissure, surgery is often required to treat it.

Some symptoms that may be experienced in anal fissures are sharp pain during bowel movement, bloody stools, visible tear of the skin around the anus, itchiness or irritation, a solid lump of skin around the affected site, and spasming of the anal sphincter.

Conclusion

While some of the experienced symptoms can be embarrassing and uncomfortable to talk about, these anal diseases should not be left untreated. In fact, doing so can lead to unfavourable consequences that may impact your lifestyle. Do not be embarrassed about conducting a gastroenterology visit.

Here at GUTCARE, our gastroenterologists have seen and treated all sorts of conditions and symptoms, such as pancreas cancer symptoms and IBS symptoms. Getting your anal disease checked can be done discreetly. Do not hesitate to treat it as soon as you experience some of the abovementioned signs.