Piles (haemorrhoids) are swellings that develop inside and around the back passage (anal canal). There is a network of small veins (blood vessels) within the lining of the anal canal. These veins sometimes become wider and engorged with more blood than usual. The engorged veins and the overlying tissue may then form into one or more swellings (piles).
Piles can be divided into either internal or external piles. Some people develop internal and external piles at the same time
Straining puts pressure on veins in the anus or rectum, causing hemorrhoids. Any sort of straining that increases pressure on your belly or lower extremities can cause anal and rectal veins to become swollen and inflamed. Hemorrhoids may develop due to:
Signs and symptoms of usually depend on the type of hemorrhoid.
These are under the skin around your anus. Signs and symptoms might include:
Internal hemorrhoids lie inside the rectum. You usually can't see or feel them, and they rarely cause discomfort. But straining or irritation when passing stool can cause:
If blood pools in an external hemorrhoid and forms a clot (thrombus), it can result in:
Piles, which are found incidentally and are of a small size without causing any symptoms can be left alone.Depending on the severity, piles are graded from grade 1-4. Generally grade 1 and 2 piles can be managed without any surgery while grade 3 and 4 usually require a surgeons help for treatment
The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:
An anal fissure is a tear in the lining of the anus or anal canal (the opening through which stool passes out of the body). The fissure can be painful and may bleed.
An anal fissure most often occurs when passing large or hard stools. Chronic constipation or frequent diarrhea can also tear the skin around your anus. Other common causes include:
In rare cases, an anal fissure may develop due to:
Anal fissures are common during infancy.
Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area.
During and after childbirth, women are at risk for anal fissures due to straining during delivery.
People with Inflammatory bowel disease also have a higher risk for developing anal fissures.
People who frequently experience constipation are at an increased risk for anal fissures
An anal fissure may cause one or more of the following symptoms:
Usually, an anal fissure can be diagnosed by visual inspection of the anus or by gentle exam with the tip of the finger.
If the anal fissure fails to respond to medical treatment, a surgical procedure called anal sphincterotomy is required. This surgical procedure involves making a small incision in the anal sphincter to relax the muscle. Relaxing the muscle allows the anal fissure to heal.
An anal fistula is a small channel that develops between the end of the bowel and the skin near your back-passage (anus).
An anal fistula is usually caused by an infection near your back passage (anus) that causes a collection of pus (abscess) in the nearby tissue. When the pus drains away, it can leave a small channel (fistula) behind. An anal fistula may also be associated with certain long-term bowel conditions.
The leading causes of an anal fistula are clogged anal glands and anal abscesses. Other, much less common, conditions that can cause an anal fistula include:
The signs and symptoms of an anal fistula include:
An anal fistula is usually diagnosed by examining the area around the anus to look for an opening (the fistula tract) on the skin. In many cases, there will be drainage from the external opening.
Some fistulas may not be visible on the skin's surface. In this case additional tests may be needed:
Surgery is almost always necessary to cure an anal fistula. The surgery is performed by a colon and rectal surgeon. The goal of the surgery is a balance between getting rid of the fistula while protecting the anal sphincter muscles, which could cause incontinence if damaged.
Fistulas in which there is no or little sphincter muscle involved are treated with a fistulotomy. In this procedure, the skin and muscle over the tunnel are cut open to convert it from a tunnel to an open groove. This allows the fistula tract to heal from the bottom up.
In the case of a more complex fistula, the surgeon may have to place a special drain called a seton, which remains in place for at least 6 weeks. After a seton is placed, a second operation is almost always performed:
You can greatly reduce your risk of an anal fistula by avoiding constipation, keeping your stools soft and going to the toilet to open your bowels as soon as you feel the urge to go. To help your bowel work properly and keep your stools soft, it's important to drink lots of fluid and get regular physical exercise.
A pilonidal sinus is a small hole or tunnel in the skin. It may fill with fluid or pus, causing the formation of a cyst or abscess. It occurs in the cleft at the top of the buttocks. A pilonidal cyst usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor.
A pilonidal sinus is a condition that mostly affects men and is also common in young adults. It’s also more common in people who sit a lot, like cab drivers.
The exact cause of pilonidal cysts isn't clear. But most pilonidal cysts appear to be caused by loose hairs that penetrate the skin. Friction and pressure — skin rubbing against skin, tight clothing, bicycling, long periods of sitting or similar factors — force the hair down into skin. Responding to the hair as a foreign substance, the body creates a cyst around the hair.
You may not have any noticeable symptoms at first other than a small, dimple-like depression on the surface of your skin. However, once the depression becomes infected, it will quickly develop into a cyst (a closed sac filled with fluid) or an abscess (a swollen and inflamed tissue where pus collects).
If you have a chronic pilonidal cyst or it has gotten worse and formed a sinus cavity under your skin, it’s a serious case and you may need surgery to excise (remove) the cyst entirely. Afterward, the surgeon might either leave the wound open for packing (inserting gauze) or close the wound with sutures or a skin flap (skin taken from a healthy part of your body).
The large intestine (also called the colon) consists of the ascending, transverse, descending and sigmoid colon. The rectum is the last portion of the large intestine. Ulcerative Colitis occurs when the lining of your large intestine (also called the colon), rectum, or both becomes inflamed.
This inflammation produces tiny sores called ulcers on the lining of your colon. It usually begins in the rectum and spreads upward. It can involve your entire colon.
The inflammation causes your bowel to move its contents rapidly and empty frequently. As cells on the surface of the lining of your bowel die, ulcers form. The ulcers may cause bleeding and discharge of mucus and pus.
Researchers believe that UC may be the result of an overactive immune system. However, it’s unclear why some immune systems respond by attacking the large intestines and not others.
Factors that may play a role in who develops UC include:
The seriousness of Ulcerative Colitis symptoms varies among affected people. The symptoms can also change over time.
People diagnosed with Ulcerative Colitis may experience periods of mild symptoms or no symptoms at all. This is called remission. However, symptoms can return and be severe. This is called a flare-up.
Ulcerative colitis symptoms often get worse over time. In the beginning, you may notice:
Later you may also have:
Tests to diagnose UC often include:
Blood tests are often useful in the diagnosis of UC. A complete blood count looks for signs of anemia (low blood count). Other tests indicate inflammation, such as a high level of C-reactive protein and a high sedimentation rate. Your doctor may also order specialized antibody tests.
There’s no cure for ulcerative colitis, but treatments can calm the inflammation, help you feel better and get you back to your daily activities. Treatment also depends on the severity and the individual, so treatment depends on each person’s needs. Usually, healthcare providers manage the disease with medications. If your tests reveal infections that are causing problems, your healthcare provider will treat those underlying conditions and see if that helps.
The goal of medication is to induce and maintain remission, and to improve the quality of life for people with ulcerative colitis. Healthcare providers use several types of medications to calm inflammation in your large intestine. Reducing the swelling and irritation lets the tissue heal. It can also relieve your symptoms so you have less pain and less diarrhea. Different types of medications used for the treatment of Ulcerative Colitis include
Surgery is an option if medications aren’t working or you have complications, such as bleeding or abnormal growths. You might develop precancerous lesions, or growths that can turn into colorectal cancer. A doctor can remove these lesions with surgery (a colectomy) or during a colonoscopy.
sometime during their life.
There are two kinds of surgery for ulcerative colitis:
The proctocolectomy and ileoanal pouch (also called J-pouch surgery) is the most common procedure for ulcerative colitis. This procedure typically requires more than one surgery, and there are several ways to do it. First, your surgeon does a proctocolectomy — a procedure that removes your colon and rectum. Then the surgeon forms an ileoanal pouch (a bag made from a part of the small intestine) to create a new rectum. While your body and newly made pouch is healing, your surgeon may perform a temporary ileostomy at the same time. This creates an opening (stoma) in your lower belly. Your small intestines attach to the stoma, which looks like a small piece of pink skin on your belly.
After you heal, waste from your small intestines comes out through the stoma and into an attached bag called an ostomy bag. The small bag lies flat on the outside of your body, below your beltline. You’ll need to wear the bag at all times to collect waste. With proper care, the pouch doesn’t smell and isn’t noticeable under clothes.
Once you and the ileoanal pouch have healed, your surgeon will discuss taking down the ileostomy.
Your new ileoanal pouch still collects stool. That allows waste to exit your body through your anus as it would normally. Afterward, because you have less space in your large intestine to store poop, you’ll have frequent bowel movements (on average four to eight times a day once your body has adjusted). But you should feel a lot better when you recover from the surgery. The pain and cramping from ulcerative colitis should be gone.
If an ileoanal pouch won’t work for you, your healthcare team might recommend a permanent ileostomy (without an ileoanal pouch). Your surgeon does a proctocolectomy to remove your colon and rectum. The second part of this surgery, done at the same time, is to perform a permanent ileostomy