Anorectal Region Benign Diseases

The last part of the large intestine continues with the rectum and ends with the anus. Benign diseases of these two regions (anorectal) lead to consequences that impair the quality of life such as constipation, bleeding, pain and fecal incontinence in daily life.

The main benign anorectal diseases are as follows;

• Anal fissure

• Anorectal abscess

• Anal fistula

• Benign anal tumors

• Rectal prolapseus (intestinal prolapse)

• Pilonidal sinus (pilonidal sinus)

• Anal canal stenosis

• Pruritis ani (anal itching)

• Fecal incontinence

Main symptoms of anorectal region diseases;

• Bleeding 

• Pain

• Altered bowel movements

• Discharge (mucus, pus)

• Feeling of defecation

• Prolapse

• Itching

• Weight loss

• Fecal incontinence / hygiene problems

 

Correct treatment of diseases in this region is very important as it may affect the patient's ability to retain stool in the future. Correct treatment starts with the correct diagnosis. The main diagnostic method is physical examination. Afterwards, sigmoidoscopy should be performed, which allows imaging of the anus and rectum and, if necessary, biopsy.

 

What is hemorrhoid?

 

Hemorrhoidsare vascular bundles located in the anal canal. It takes place in every person. When they grow and become symptomatic, they become diseases. Conservative treatment is effective in the initial period. Conservative treatment;

• Diet (increasing the amount of fiber)

• Stool softeners

• Sitz bath

• Topical creams

• Consists of drugs that increase venous tone.

 

Patients unresponsive to medical treatment; sclerotherapy, rubber band ligation and laser can be applied.

Surgical treatment is applied to patients who fail other treatment methods.

 

What is anal fissure?

It is called the cracks at the entrance of the anus. It often causes pain, burning and bleeding after defecation.

How is anal fissure treated?

Initially, fiber intake in the diet is increased. Medicines to prevent constipation are taken. Sitz baths in warm water and creams that relax the sphincter muscles surrounding the anus are used.

If these treatments do not work, Botox (botilinum toxin) injection or surgical treatment is applied.

In surgery, a part of this muscle is cut and loosened.


 

Rectal Prolapse

It is the prolapse of all layers of the rectum and anal canal due to straining. The intestine may prolapse in full thickness, or only the inner part, which we call the mucosa, may prolapse. Itching or mucous discharge from the anus may occur. In the beginning, diet and avoiding overexertion may be sufficient. Hemorrhoidopexy can be performed with a "stapler" only in patients with sagging mucosa.

Various surgeries are performed in patients with full-thickness prolapse. The type of surgery to be chosen depends on the patient's age and general condition. It can be done from the abdomen or anus.

One of the methods performed from the abdomen is "anterior mesh rectopexy". After the rectum is freed, it is fixed by hanging it with the help of a patch.

It is done safely, especially laparoscopically or robotically. With robotic systems, the rectum can be separated from the vagina in the front.





 

What is Fecal Incontinence?

 

The capacity of individuals to retain stool is called fecal continence, and the loss of this ability is called fecal incontinence. Being able to hold feces is a complex mechanism that starts from the brain and ends in the anus. Fecal incontinence problem most often occurs due to birth injury. Anorectal region surgeries, some neurological diseases (multiple sclerosis, Parkinson's, etc.), traumas, inflammatory bowel diseases and diarrhea may also cause fecal incontinence.

 

How is fecal incontinence treated?

Diagnosis and treatment of the disease requires a multidisciplinary approach. General surgery, gastroenterology, Neurology and radiology must evaluate the patient together.

The severity of fecal incontinence is important in choosing the treatment. In mild cases, diet and diarrhea treatment may be sufficient. In addition, repair of these muscles or injections of collagen substances into them are also among the options for patients with damage to the anal sphincter muscles that enable stool retention. In patients who do not respond to these, sacral nerve stimulation has become increasingly common in the treatment of incontinence in recent years and its results are quite successful. Sacral nerve stimulation (NSS) can be used effectively in patients with damage to the anal sphincter, some neurological diseases, and low anterior resection syndrome that develops after rectal cancer surgery. Sacral nerve roots are stimulated by electrostimulation. This is achieved by transmitting the electrical current sent from a device placed under the skin through electrodes extending to the sacral nerve roots.

 

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