Annals Diseases

The anal canal is the area of ​​the digestive canal running through the pelvic muscles of the anal sphincters and with 4 to 5 cm in length in adults, being the end anus orifice through which the feces out of the body. The lower half of the anal canal has sensory nerve endings. There blood vessels under the coating and its middle portion there are numerous small anal glands. This article describes four disorders that cause anal pain and irritation:

• anal fissure - An anal fissure is a tear or fissure in the lining of the lower anal canal. Most anal fissures occur when faeces excessively bulky and hard distend the anal opening and anal tear the coating. Less often, anal fissures develop due to a prolonged diarrhea an inflammatory bowel disease or sexually transmitted disease involving the anorectal area. Anal fissures acute (short-term) are usually superficial, while chronic anal fissures (long-term) can be deeper, exposing the surface of the underlying muscle.

• Anal Abscess - An anal abscess is a painful collection of pus, followed by edema, located near the anus. Most anal abscesses are not related to other health problems arise spontaneously and, for unclear reasons, resulting in a small anal gland which increases in volume to create a loca infected under the skin. Anal abscesses occur most frequently in young adults between 20 and 40 years, being more common in males. Most anal abscesses are located near the opening of the anus but rarely occur in an area deeper or higher anal canal, near the lower portion of the colon or pelvic organs.

• Anal fistula - An anal fistula is an abnormal path, resembling a tunnel establishing a connection between the middle portion of the anal canal and the surface of the skin near the anus. The fistula is often a structure reminiscent of an old anal abscess after having been drained (either spontaneously or after being lanced by a physician), a complication that occurs in at least half of cases of anal abscesses. Sometimes the fistula opening on the skin surface constantly drain pus or bloody fluid. In other cases, the fistula opening is closed temporarily, causing the former to reappear anal abscess, forming a painful pus-filled bag.

• Hemorrhoids - Hemorrhoids are enlarged, bulging blood vessels in the anal canal, around the anus (external hemorrhoids) or inside the anus and the lower portion of the rectum (internal hemorrhoids). Hemorrhoids usually do not cause pain. However, sometimes blood vessels of a hemorrhoid small located at the edge of the anal orifice can become blocked by a blood clot ("thrombosis") which can be triggered by a period of constipation or diarrhea. When thrombosis occurs, the external hemorrhoid becomes swollen, hard and painful, sometimes with a bloody exudate.

Prevention

It is possible to reduce the risk of anal fissure by preventing constipation, making it softer stools. For this, the patient should gradually increase the amount of fiber in your diet, drink 6-8 glasses of water a day and exercise tolerance. Fiber supplements currently marketed are effective.

Although not always possible to prevent other types of anal disease, may decrease the risk of these diseases through the following measures:

• using gentle techniques to clean the anal area

• keeping the area dry, changing underwear frequently and using powder to absorb moisture

• always using a condom in the case of the practice of anal intercourse

• never entering any foreign body in the anus.

Treatment

Once performed the diagnosis, the treatment of anal diseases can involve or not to carry out an operation, depending on the specific disease. If surgery is necessary, the doctor will use an appropriate anesthesia to help prevent the pain in this very sensitive area.

• Anal fissure - In acute fissure, the doctor may recommend that the patient fulfills the measures to prevent constipation described above (in the section on Prevention) and can advise you to immerse the anal area in warm water for 10 to 15 minutes several times per day (sitz bath) and apply an ointment in anal fissure (topical anesthetics and / or ointments that reduce the spasm of the anal sphincter). In chronic fissures, surgery can correct the problem in 90% of cases.

• Anal abscess - An anal abscess should be opened or lanced by a doctor to drain the pus. This procedure (incision and drainage) can generally be performed on an outpatient basis, especially in case the person is young and healthy abscess is close to the anal orifice.

• Anal Fistula - surgery to open the fistulous track ("fistulotomy") is the most effective therapy. The doctor opens the route and scrape any remaining infected abscess anal old. The wound is left open to heal by secondary intention. If the fistula is associated with Crohn's disease, the treatment is directed to this disease, comprising the administration of anti-inflammatory drugs in combination with an antibiotic.

• Hemorrhoids - General treatment of hemorrhoids consisting of fiber supplements to decrease stool consistency, often by immersion in lukewarm water ("sitz baths") and the use of locally applied drugs. The symptomatic hemorrhoids that do not advance the implementation of these measures may require other interventions such as elastic ligation, sclerosis or surgical removal of hemorrhoids. The thrombosed external hemorrhoid usually regress spontaneously but the process could be accelerated if the physician to perform a small incision in the haemorrhoid so as to leave the clot under local anesthesia.