Diagnosing & treating anorectal disorders


Diseases of the rectum and anus (anorectal disorders) are common, and most likely, the prevalence among the general population is higher than what we see in clinical practice. This is because many people suffering from these conditions do not seek medical care. And it’s understandable. It can be embarrassing to talk about problems with the rectum or anus. 

Anorectal disorders occur at the junction of the anal canal and the rectum. Our surgeons are trained in diagnosing and treating these disorders, and there is nothing they haven’t seen before. Seeing a doctor about these troubles is very important, so let’s look more closely at some of the most common anorectal disorders. 

Anorectal disorders: signs, symptoms, and treatment

Your physician will perform an exam to determine the best course of treatment. The good news is that many anorectal problems are treatable when recognized early and properly diagnosed. Often, there are treatment options that do not involve surgery or complicated procedures. However, sometimes, we do determine that a more involved treatment is necessary. 

Remember that symptoms of rectal pain or bleeding should always be thoroughly evaluated by your doctor as they can be signs of very serious conditions.

Anal abscess or fistula 

An abscess is a cavity filled with pus, and most often this results from a blockage of the anal glands. A fistula is a connection or tunnel between the anal gland and the buttocks, usually very close to the anal opening. An anal fistula is almost always the result of an anal abscess. There are other problems, such as Crohn’s disease or an anal fissure which may be the underlying cause of the fistula. 

Abscesses produce considerable pain and swelling next to the anal opening. A fistula produces drainage from the anal canal to the opening of the fistula on the buttocks. 

Anal fissure

An anal fissure is a tear or split in the lining of the anus. It usually causes significant pain with and after bowel movements. Sometimes a skin tag or swelling can be felt adjacent to the fissure that can be confused for a hemorrhoid. Usually this is caused by having hard stools or more rarely having too many loose stools. Treatment involves stopping the underlying cause to allow the fissure to heal. Sometimes an operation is required if symptoms do not resolve.

Pruritus ani

Pruritus ani refers to itching around the anal area, which is often most troublesome at night or following a bowel movement. Common causes include excessive cleaning or wiping and excessive sweating in the anal area. In rare cases, infectious skin conditions can cause the problem. Some beverages, including alcohol, citrus, and caffeine-containing drinks, may make pruritus ani worse. It is important to note that poor hygiene is usually not the cause. 

Avoiding irritating soaps, especially those containing perfumes, can help the problem. It’s also best to gently blot the area with a moist washcloth, rather than rubbing or scratching. Eliminating irritating foods and beverages such as coffee, alcohol, and spicy foods may also help. 

Rectal bleeding

Many conditions can cause rectal bleeding, but all cases should be evaluated to identify the cause. Significant conditions, such as cancers and polyps, can bleed regularly or intermittently. The most common causes of rectal bleeding include hemorrhoids, fissures, and polyps. Risk factors that often lead to further investigation include older age, family history of bowel disease or cancer, and the non-resolution of the bleeding after treatment of the suspected cause. Total colon examination with a colonoscopy may be required. 

Despite any embarrassment that may go along with these anorectal conditions, once again, we urge you to seek treatment if you are having any symptoms or issues mentioned above. The answer to your problem may be relatively simple, requiring at-home treatment and lifestyle changes. The answer could also be that further testing to diagnose a larger problem is necessary. The physicians at Alabama Colon and Rectal Institute are here to help no matter what the case may be. 

Alabama Colon & Rectal Institute is centered around treating diseases of the colon, rectum, and anus.

Alabama Colon & Rectal Institute (also known as the “Butt Hutt” around town!) has been in practice since 1990 as a free-standing, private practice located in downtown Birmingham, Alabama.  We are known for our efficiency and patient care, in a more relaxed office-based setting.  Our doctors are known regionally for their expertise and are active in teaching surgical residents and other physicians.  We are also a major sponsor of The Rumpshaker 5K, a race that promotes awareness about colorectal cancer.  Check out our website for more information, or give us a call to make an appointment at (205) 458-5000, or email us at [email protected].