Proctology: diseases — симптомы, диагностика и лечение

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.

Blood in the stool is not a diagnosis, but a sign that can come from any part of the digestive tract. The brighter the blood, the lower its source tends to be: scarlet blood on toilet paper is more often associated with hemorrhoids or anal fissure, dark mixed blood with the colon, and black, tarry stool with the stomach or duodenum. Even if a person is sure that the problem is hemorrhoids, it is impossible to attribute the blood only to hemorrhoids: polyps, inflammatory bowel diseases and a tumor may be hidden under the same picture. Therefore, any episode of blood in the stool is a reason to be examined.

Fecal incontinence is the involuntary release of gas, liquid or formed stool. A whole system is responsible for retention: two anal sphincters, pelvic floor muscles, rectal sensitivity and its ability to stretch, as well as stool consistency. Failure of any link leads to loss of control. The most common causes are sphincter injury during childbirth or after surgery, age-related muscle weakening, nerve damage due to diabetes and neurological diseases, and chronic diarrhea. This condition greatly affects life, but in many cases it can be treated, and it is necessary to contact a proctologist.

Perianal dermatitis is an inflammation of the skin around the anus, which is manifested by itching, burning, redness, weeping and cracking. The skin here is thin, constantly in folds and in contact with moisture, so it is easily damaged. There is rarely one reason: irritation from the contents of the intestines with frequent bowel movements or leakage, excessive hygiene with soap and wet wipes, as well as proctological problems - hemorrhoids, fissure, fistula - are often combined. Separately, fungal and bacterial infections, helminthic infestations in children, psoriasis and diabetes mellitus are considered. That is why treatment begins not with an ointment, but with a search for the cause: without eliminating it, the itching returns again and again.

Rectal polyps are growths of the mucous membrane that protrude into the intestinal lumen. Most of them do not give any symptoms for a long time and are discovered accidentally during endoscopy. The significance of polyps is that adenomatous forms are considered precursors of colorectal cancer: the path from a small adenoma to a malignant tumor takes years, and it can be interrupted by timely removal. Therefore, the found polyp is usually removed and sent for histological examination. After removal, a control colonoscopy is prescribed, the interval of which depends on the number, size and structure of the polyps.

Proctitis is inflammation of the rectal mucosa. It is manifested by burning and pain in the anus, mucus and blood during bowel movements and a very characteristic symptom - false urges, when the intestine persistently asks for emptying, but there is almost no stool. The reasons are different: intestinal infections and sexually transmitted infections, inflammatory bowel diseases, radiation therapy of the pelvic organs, trauma and impaired blood supply. Treatment depends entirely on the cause, so examination by a proctologist and endoscopy are important, rather than selecting suppositories at random. Blood in the stool always requires exclusion of a tumor.

Anal cancer is a malignant tumor of the final section of the intestine, most often squamous cell. It differs from rectal cancer both in structure and in treatment. Long-term carriage of high-risk human papillomavirus plays a key role in development, so the disease is associated with the same mechanisms as cervical cancer. The main difficulty is that the first signs - blood during bowel movements, pain, itching, a feeling of compaction - are almost indistinguishable from hemorrhoids, and people have been treating themselves for years. Meanwhile, a tumor detected in time in most cases is cured without removing the rectum.

Rectal cancer is a malignant tumor of the final section of the large intestine, part of the group of colorectal cancer. In most cases, it develops from an adenomatous polyp, and this path takes years, so the disease is preventable: a polyp removed in time does not turn into a tumor. The insidiousness of rectal cancer is that for years people have attributed its first signs - blood in the stool, changes in the frequency and shape of stools - to hemorrhoids. Any admixture of blood in an adult requires examination by a proctologist and endoscopy, and from the age of 45, examination of the intestines is indicated even without complaints.

Mucus is produced by the cells of the intestinal mucosa: it lubricates the contents and protects the wall from damage. A small amount of it is always present in the stool, just usually unnoticed. A reason to think about it is clearly visible mucus: transparent or whitish strands on the surface of the stool, mucus separate from the stool, especially if this is repeated. The reasons can be harmless - constipation, dietary errors, hemorrhoids, irritable bowel syndrome. But the same picture occurs with intestinal infections and inflammatory bowel diseases. The main landmarks are blood, fever, weight loss and duration of complaints: they determine how urgently an examination is needed.

The word "colitis" means inflammation of the colon. This is not one diagnosis, but a general name for conditions with different causes: infectious, immune, vascular, medicinal, radiation. Chronic colitis is called when symptoms - abdominal pain, unstable stools, mucus, sometimes blood - persist for more than several weeks or recur regularly. Often, “chronic colitis” hides other diseases for years: ulcerative colitis, Crohn’s disease, microscopic colitis, irritable bowel syndrome, or even a tumor. Therefore, the main task is not to find a “cure for colitis”, but to find out exactly what disease is causing the complaints.