Proctology: 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.

Anal fimbria are soft folds of skin around the anus that remain after inflammation of the hemorrhoids, thrombosis of the external node, anal fissure or childbirth. This is not a tumor or hemorrhoids, but stretched skin that no longer shrinks back. Fringes do not hurt or bleed, but they interfere with hygiene, cause moisture, irritation and itching, and disturb many people externally. There are usually no medical indications for removal: the intervention is performed at the request of the person or when the folds are constantly inflamed and make it difficult to care for the area.

Anal itching is an unpleasant, sometimes painful sensation of itching and burning in the anus. It can be mild and episodic or constant, worsening at night and disrupting sleep. Many people are embarrassed to consult a doctor about this problem and use random ointments for years. Meanwhile, anal itching has many causes: excessive or insufficient hygiene, humidity, hemorrhoids and anal fissures, rectal discharge, pinworms, fungal infections, allergic dermatitis to hygiene products, psoriasis, diabetes mellitus. A proctologist, through examination and simple tests, usually quickly finds the cause, after which the itching is successfully treated.

Crohn's disease is a chronic immune-inflammatory disease in which inflammation can affect any part of the digestive tract from the mouth to the anus, but most often the final part of the small intestine and large intestine. The inflammation covers the entire thickness of the intestinal wall and is located in areas between which healthy mucosa remains. The disease occurs in waves of exacerbations and remissions and is manifested by abdominal pain, diarrhea, weight loss and weakness, and over time can be complicated by narrowing of the intestine, fistulas and abscesses. It is not yet possible to completely cure Crohn's disease, but modern therapy allows most patients to live a full life in long-term remission.

Hemorrhoids during pregnancy are enlargement and inflammation of the cavernous plexuses of the rectum and anus. It worsens in many women, and the reasons are natural: the growing uterus compresses the pelvic veins, progesterone relaxes the vascular wall and slows down the intestines, and blood volume is increased. Add to this constipation and straining - and the nodes swell, begin to hurt and bleed. During childbirth, the pressure on the plexuses increases sharply, so often the first exacerbation occurs precisely after pushing. The good news is that most women's condition improves after childbirth, and safe treatment is possible during pregnancy.

Diverticula are small pouch-like protrusions of the intestinal wall that most often form in the sigmoid colon in people over 50 years of age. Their presence is called diverticulosis; in most people it is asymptomatic and is discovered incidentally during a colonoscopy or CT scan. If the diverticulum becomes inflamed, diverticulitis develops - with pain in the left lower abdomen, fever and changes in bowel movements. Diverticulitis can be complicated by an abscess, bowel perforation, fistula, or bleeding. Proper nutrition and timely treatment of inflammation allow most patients to do without surgery.

Coccydynia is pain in the coccyx area, which usually worsens when sitting or standing up. It is more common in women, which is associated with the structural features of the pelvis and childbirth. The most common causes are a fall on the buttocks, trauma to the coccyx during childbirth, prolonged sitting on a hard surface, as well as excessive mobility or displacement of the coccygeal vertebrae. Sometimes the source of pain is the pelvic floor muscles or diseases of the pelvic organs and rectum. Coccydynia itself is not dangerous, but it can greatly impair the quality of life. It usually resolves within a few weeks or months with conservative treatment; It is important to consult a doctor to rule out epithelial coccygeal tract, tumors and inflammatory processes.

Colorectal cancer is a malignant tumor of the colon or rectum, one of the most common cancers in the world. In most cases, it develops slowly, over 10–15 years, from benign polyps - adenomas. This makes colorectal cancer one of the few that can not only be detected early, but also prevented: removing the polyp during a colonoscopy interrupts the path to cancer. In the early stages, the tumor usually does not cause symptoms, but blood in the stool, changes in stool, anemia and weight loss appear later. That is why screening is recommended for people without complaints starting at age 45, and earlier if there is an increased risk.

Cryptitis is an inflammation of the anal crypt, a small pocket in the wall of the anus into which the ducts of the anal glands open. The anal papillae are located nearby, and when they become inflamed they are referred to as papillitis. Usually the cause is trauma with dense feces or prolonged diarrhea: the contents are retained in the crypt, the ducts become clogged, and an infection develops. A person is bothered by burning, wetness, foreign body sensation and pain that increases with defecation. The condition is not dangerous, but requires attention: it is from the inflamed crypt that acute paraproctitis with an abscess most often develops, and then a rectal fistula, which can only be treated surgically.