Coloproctology: diseases — симптомы, диагностика и лечение

Hemorrhoids are the enlargement and prolapse of hemorrhoids, cavernous vascular formations that every person normally has and are involved in retaining the contents of the intestine. They become a problem when, due to increased pressure and stagnation, they increase in size, begin to bleed and fall out. This is one of the most common diseases that people are embarrassed to talk about, and that is why people have been treating themselves for years. Meanwhile, the main danger is not in hemorrhoids itself, but in the fact that other diseases, including rectal cancer, are manifested by blood during bowel movements.

An anal fissure is a linear rupture of the anal mucosa. Despite its small size, it causes pain that patients describe as one of the worst in their lives: a feeling of broken glass during and after bowel movements. The basis is a vicious circle: the fissure causes pain, the pain causes sphincter spasm, the spasm impairs blood supply, and the fissure does not heal. Because of fear of pain, a person puts off going to the toilet, the stool becomes even harder - and everything repeats. It is impossible to break this circle without relieving the spasm and softening the stool.

Acute paraproctitis is an abscess in the fatty tissue around the rectum and anus. It almost always begins the same way: the infection penetrates from the intestinal lumen through the inflamed anal gland, and a cavity with pus forms in a confined space in a matter of days. The main thing you need to understand from the very first hours is that pus does not resolve. Neither ointments, nor tablets, nor warm baths will make it disappear - they only provide a few days of imaginary relief, during which the inflammation manages to go deeper and destroy more tissue. The only treatment method is to open and drain the cavity surgically. This is not a situation in which you can “wait until Monday”: paraproctitis is a condition that requires emergency surgery.

A rectal fistula is a narrow canal connecting the intestinal lumen to the skin of the perineum. Most often, it remains after suffering acute paraproctitis: the abscess has opened or was opened, the inflammation has subsided, but the passage from the affected anal crypt to the outside has been preserved and is lined from the inside with dense tissue. The key feature that causes most disappointments is that such a channel does not overgrow on its own. Its walls are constantly washed by the contents of the intestine, the infection comes again, and no ointments, suppositories or courses of antibiotics can close the lumen, which has a constant source. The fistula can only be treated surgically, and the whole difficulty of the task is not in removing it, but in removing it without damaging the muscle responsible for retention.

Rectal prolapse is a condition in which the wall of the intestine moves down and exits through the anus. At first this happens only with strong straining and reduces itself, then with any strain and coughing, and in the later stages the intestine remains outside constantly. The disease is rare, but it has a feature that worsens the statistics more than the pathology itself: it is embarrassing to talk about. People live with prolapse for years, without even telling their loved ones about it, they try to cope with pads and manual adjustments, and they come to the doctor when retention is already impaired. This is fundamentally important, because in the early stages the treatment result is noticeably better, and the volume of surgery is less.

Colon polyp is a growth of mucous membrane into the intestinal lumen. By itself, it almost never hurts or interferes, and this is the main difficulty: polyps are found not because a person complains about something, but because he had a colonoscopy. Moreover, the vast majority of cases of colon cancer develop from adenomatous polyps, and this path takes years. Hence the simple logic: a polyp removed in time means cancer prevented. Colonoscopy remains the only test that both finds and immediately eliminates the problem.

Irritable bowel syndrome is a functional disorder in which there is abdominal pain and bowel movements, but no structural changes are found on examination. Patients often hear “you’re fine” and are left alone with symptoms that seriously limit their lives. Meanwhile, IBS is a real diagnosis with an understandable mechanism: the interaction between the intestines and the brain is disrupted, the sensitivity of the intestinal wall is increased, and motility is altered. And, importantly, it responds well to treatment - it’s just that this treatment is different from the usual one.