Common anorectal conditions – What they are, how they arise, and how to treat them

Common anorectal conditions rarely cause for concern. However, conditions such as abscesses, fistulae, fissures, hemorrhoids, and pruritus ani (itching) can have a harmful effect on your quality of life and well-being. Additionally, they may be misdiagnosed and associated with more severe complications.  

We’ve highlighted a few of the common anorectal conditions that may be pinpointed and managed at our center:

• Anal abscesses arise in the tissues around the anus. This collection of pus develops when bacteria become lodged in the glands that reside between the inner and outer layers of the anal sphincter muscle. The resulting infection can spread beyond the anal canal to surrounding tissue and structures. The pressure caused by the pus produces swelling and persistent throbbing pain. To relieve these symptoms requires drainage of the pus from the abscessed cavity. Occasionally, the abscess may discharge itself but its very likely to recur. Antibiotics don’t treat the problem effectively as abscesses have a capsule that does not allow antibiotics to reach the abscess cavity. Formal incision and drainage of the abscess and subsequent packing allow controlling of the infection. One in three anal abscesses may develop into a fistula that arises from the anal glands.

• Anal fistulae are abnormal communication between the anus and the skin. The infection extends from the anus through the fistula into the skin. This leads to recurrence of the abscess or ongoing discharge of pus or blood-stained fluid. The management can be complex and depends on multiple factors. Dr. Ganesh will determine based on history, examination and sometimes MRI scan of the rectum/anus to determine the best course of treatment.

Anal fissures are small rips or tears in the lining of the anal canal. While common, fissures are often mistaken for other conditions, such as hemorrhoids. Surgery is rarely necessary, and we may recommend fiber supplements, topical and dietary adjustments to promote softer, better-formed, and use of rectogesic ointment to heal the fissure.. Surgical treatment for chronic fissures aims to relax the sphincter muscle. In doing so, pain and spasms are alleviated, and the fissure can heal properly. Surgical management can be either injection of Botox to the anla sphincters or cutting a small amount of sphincter muscle to relax the sphincter and allow healing to take place.