Anal Region Diseases

Anal Region Diseases

2022-05-20 09:06:09/ Kategori : Gynecology and Obstetrics, Internal Medicine (Internal Medicine)

People from all genders and age populations, regardless of women, men, children, or older, have experienced one or more of the complaints of constipation, rectal pain, burning, swelling or bleeding at some point in their life. However, most of us, regardless of gender, social status, or intellectual level, instead of going to the doctor with these complaints, we go to the path of healing with hear-filled treatments or prescription drug cures from the pharmacy. Some got better, some got worse, but we postponed going to the doctor until the symptoms became unbearable.

Colon cancer is the third most common type of cancer in men after lung and prostate cancer in the world and in our country. In women, it is the second most common in the world, and it is the third most common after breast and thyroid cancer in our country. As with all cancers, early diagnosis saves lives in colon cancer. Findings such as pain in the rectum, bleeding, deterioration in defecation may be caused by simple hemorrhoidal disease (hemorrhoids) or anal fissure (anal fissure), as well as the first symptoms of colon cancer.

Bleeding from the rectum is the most common finding in hemorrhoidal disease. In 20-30 of every 100 000 patients, there is a complaint of bleeding after defecation, drip during defecation or while cleaning afterwards. Most of the time, bleeding is accompanied by swelling in the rectum, which is called “breast”. Most of the patients have a history of constipation, prolonged straining, sitting on the toilet for a long time, or recent pregnancy. Today, it often develops due to bad eating habits and defecation disorders. In fact, what we call hemorrhoidal pouches among the people is the vascular pads that normally feed the last part of the large intestine in our breech region and are located on three sides of the intestinal wall (Picture 1, 2).

These pads become prominent by swelling in situations that increase intra-abdominal pressure, such as chronic constipation, prolonged straining, inflammatory bowel disease, and the last period of pregnancy. Involuntary contraction in the anus due to the added pain at this stage causes the blood in the pads to pool and coagulate. When holding the toilet due to fear of pain is added to the involuntary contraction, a vicious circle is entered. The sooner the neck of the pillows loosens, the faster the blood in it continues to circulate and the disease regresses. Generally, hemorrhoidal disease is evaluated in four stages (Picture 3). In stage 1, there is only bleeding due to blood pooling. In stage 2, the pads that come out with straining go inside on their own after straining. In stage 3, the pads that come out during straining and defecation do not go back without being pushed by hand. In the fourth stage, the pads are constantly outside, they cannot be pushed even by hand, which is the most important reason for surgery. Generally, while drug treatment is sufficient in the first two stages, surgery is required in the 3rd and 4th stages.

Picture 3

Sometimes, the pain, which is described as a glass sinking during defecation, is in the foreground rather than bleeding. This picture may be accompanied by a blood smear on the stool and a small palpable swelling in the anus. “Anal fissure”, which is popularly called an rectal crack, is usually the underlying disease of these symptoms. Again, chronic constipation is a disease in the form of a slight tear in the breech midline with the trauma of hard stool due to irregular nutrition. The picture becomes chronic when a vicious circle is entered as a result of holding the toilet due to pain, involuntary contraction in the rectum, then hardening of the stool and reopening of the healing wound with this hardening stool trauma. It should be checked whether there is another underlying chronic inflammatory bowel disease in fissures located outside the midline. In the disease that has not become chronic, that is, not exceeding 3 months, recovery is achieved with medical treatment and recommendations. Surgery is recommended for chronic and deep cracks.

In both diseases, it is absolutely necessary to examine the entire intestine with colonoscopy before the operation and to exclude diseases that may cause similar symptoms such as intestinal cancer.

When the above-mentioned symptoms and complaints are present in the rectum, it is absolutely necessary to consult a physician in order to name the disease and direct it to the right treatment, and to prove that the colon cancer does not cause the symptoms. Hearing treatments, efforts to save the day by using drugs that are good for the neighbor may lead to delays in the diagnosis of hidden colon cancer. In cases where there are no complaints, within the framework of the Ministry of Health National Screening Program, checking stool occult blood every 2 years after the age of 50, performing a colonoscopy every 10 years in the same age period (under the conditions where no pathology is detected), not interrupting the controls as often as the physician recommends when any pathology is detected in the colonoscopy. It is essential for early detection of cancer.


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