Proctology
Among the most common conditions in general surgery — and among the most delayed. Patients wait months, sometimes years, because the subject is uncomfortable. Almost all of them are straightforward to treat once assessed. The consultation is private, brief, and handled without embarrassment.
Hemorrhoids
Swollen blood vessels in and around the anal canal. Symptoms include bright red bleeding during or after passing stool, itching, discomfort, or a lump that may protrude.
Treatment depends on severity. Many cases improve substantially with dietary fibre, adequate fluid intake and topical treatment. More advanced hemorrhoids may be treated with rubber band ligation in the clinic, and only a minority require surgery.
Anal fissure
A small tear in the lining of the anal canal, usually caused by passing a hard stool. It produces sharp pain during defecation that can continue for a long time afterwards, often with a small amount of bright red blood.
Most fissures heal with stool softeners and topical medication that relaxes the muscle and restores blood flow. Chronic fissures that don't respond may require a minor procedure.
Anal fistula
An abnormal tunnel between the anal canal and the skin, usually developing after an abscess. It causes persistent discharge and recurring abscesses. A fistula will not close on its own — surgery is required, and the technique is chosen to protect continence.
Pilonidal sinus
A cavity in the cleft at the base of the spine, most common in young men. It may cause discharge, swelling, or a painful abscess. Treatment ranges from drainage of an acute abscess to definitive excision.
One important point about bleeding
Rectal bleeding should never be assumed to be hemorrhoids. Hemorrhoids are the most common cause, but the same symptom can be produced by conditions that are far more serious, including colorectal cancer — and the two can exist together.
Any new or persistent rectal bleeding deserves a proper examination. If you have bleeding with a change in bowel habit, weight loss, or a family history of colorectal cancer, arrange assessment without delay.