Familial Adenomatous Polyposis (FAP)
Familial adenomatous polyposis (FAP) is the growth of polyps in the colon and rectal epithelium. FAP is an autosomal dominant genetic disorder that can occur in the upper portion of the small intestine too. Polyps are extra tissues that grow throughout the wall of the colon. Adenomatous polyps range from a hundred to thousands in number spread across the colon that develops into colon cancer after the age of 40 years, or into some other kind of malignancy. FAP is treated only through surgery.
FAP is resultant of germ line mutation in the APC gene, mainly inherited and spontaneous in 25% of the cases. The gene mutation manifestation begins from pre-teen, with appearance of abnormal excessive tissue outgrowth called polyps; the number multiplies with time, spreading throughout the large intestine up to the duodenum and eventually turns into malignant tissues at a later stage. FAP can also lead to other serious complications like duodenal polyps, desmoids and more.
Laser Treatment of Fistula
Anatomically, the ano-rectal region is quite a complex portion. The anal canal is richly supplied with nerves to sense and control the storage of bowel, muscles to assist with holding and expelling the bowels and glands for lubricating the faecal stuff, and ease the defecation process. Due to the nature of its function, the anal canal can become infected and cause pus deposition, forming abscess. The pus at times drains out from the buttock skin by its own, but often needs clinical intervention. Generally, the abscesses recur and leave a tract behind because of chronic pus deposition; thus resulting in formation of perianal or perirectal fistula. A proctologist confirms the fistula through physical and digital examination, and performs an ultrasound for in-depth study of the extent of infection and size of the fistula.
Anal and Rectal Stenosis
Stenosis is a term medically used to define a problem when a tubular part such as the organ canals and blood vessels for some reason start constricting in size, making the passage extremely narrow. Anal stenosis, also known as anal stricture, is a condition wherein the anal canal right before the anal sphincter narrows down and stops functioning properly. Generally, more than one factor is accountable to the occurrence of anal stricture. Constipation, strained stools, fissures, colon diseases such as Crohn’s disease, ano-rectal infection, itching, inflammation and damaged blood vessels are the common causes of stenosis. In certain cases, stenosis is congenital but most often develops after an ano-rectal surgery.
Ano-Rectal Problems in Women
The terminal segment of the digestive tract where the faecal matter is stored is called rectum and the final orifice from where the faecal matter is passed outside the body is the anus. A lot of problems arise in the anal and rectal region because of sensitive nerve endings about which people often feel too embarrassed to discuss nor seek medical help. Comparatively, women experience more ano-rectal problems due to the complex structural anatomy of their reproductive organs, adjoining the lower digestive tract. In addition, the post-partum complications further tend to aggravate the ano-rectal problems. These anomalies are quite bothering, painful and interfere with day-to-day activities.
A chronic benign ano-rectal problem of cyst at the crease of the buttock pilonidal disease is an inflamed infected dimpled hair pit. A pilonidal sinus (PNS) is a lumpy growth with debris and hair near the tailbone (coccyx) and commonly witnessed more among men than in women, occurring mostly at onset of puberty and rare after the age of 40. Male to female ratio of PNS occurrence is 3:1, the sex hormones change during puberty, aggravating the pilosebaceous glands secretion. People with PNS develop one or more cysts in the form of a dimple and hair sticking out of it at the cleft of the butt. The cyst might be infected after a while, pus and blood oozing out of it with foul smell, accompanied by severe pain and discomfort.
Sometimes the colon wall or lining develops very small out-pouches without any obvious symptoms unless detected through colon examination from other complications. The small pouches are called diverticula and the condition is known are diverticulosis. Each pouch is called a diverticulum that occurs when some portions of the gastrointestinal tract outer wall become weak as a result of which the inner wall pushes against them to form the diverticulum. Each diverticulum is about 5-10 mm in diameter. The high pressure created inside the colon region due to excessive muscular contractions during strained bowel movements forces the inner mucosal layer to tear the blood vessels of the colon wall and protrude past the serosa, forming sac like bodies. Common in as many as 80 among 100 older population, diverticulosis generally is associated with the colon. The condition is quite widespread in US and rather rare in Asia due to difference in food habits. As a person grows old, certain portions of their large intestine become fragile, resulting in prominence of diverticula formation.
Anal or genital warts, also known as condyloma, are growths of skin in the form of lesions near the ano-rectal opening or in the genital parts. Condyloma is a contagious disease caused directly from skin contact and transmitted via the Human papilloma virus (HPV). The warts can grow solitary but in clusters. The warts can also be found in the internal portion of the urethral opening or inside the female genitalia, hard or soft in texture. Initially smaller in dimension, the warts grow and spread profusely in the adjoining area that might cause bleeding. The duration from viral exposure to developing the warts can vary from 2-6 months or longer. During the latent phase, the virus remains inactive and proliferates inside the skin tissues. Most of the warts clear on their own but in some cases the latency period is followed by recurrence.
Proctitis and Rectal Prolapse
The anus is an aperture at the end of the gastro-intestinal tract from where bowels are passed out of the body. The anus constitutes partly the skin surface and partially the intestine from within. The anal sphincter controls the opening of the anal passage. The rectum is the portion of the intestinal tract right above the anal region where the bowels are held before defecation. The rectal wall is lined by mucus glands and supplied profusely with blood vessels and nerves. However, the rectal lining is comparatively insensitive to pain. As opposed to it, the anal region is highly sensitive and delicate. Together, the ano-rectal part of the digestive tract is a very important segment of the last process of digestion. The ano-rectal area can have various types of disorders like haemorrhoids, fissures, abscesses and cancer.
Any malignant or abnormal growth or mass in the colon or rectum leads to the development of colorectal cancer, also known as bowel, colon or rectal cancer. Nearly 2% of people over the age of 50 years are diagnosed with colorectal cancer in Europe, 40% of which are in the advanced stage. One of the most invasive and common types of cancers, colorectal cancer is common among both men and women, often occuring at an early age in the former. However, growing awareness, advanced medical technologies, and early detection of the disease have improved survival rates in patients since the past two decades. The colon and rectum are parts of the large intestine; the colon participates in re-absorption of water and nutrients from digested food that passes through while the rectum helps in the expulsion of faecal matter from the body. Colorectal cancer can be benign if the mass or abnormal growth is restricted to the inner lining of the colon wall, and might become malignant if the abnormal tissues grow in density and start invading into other organs and tissues.
Colon Complications Inflammatory Bowel Diseases (IBD)
Inflammatory bowel movements or inflammatory bowel diseases (IBD) are a group of idiopathic diseases of the small and large intestines occurring due to chronic inflammation and deregulated immune conditions of the digestive tract. IBDs are diagnosed in adolescence but can affect people of all age groups. One in every 250 persons reportedly suffers from some form of IBD. IBDs are mainly sub-divided into ulcerative colitis and Crohn’s disease. There are lesser known and rarer forms of IBDs namely collagenous colitis and lymphocytic colitis. Sometimes, due to conflicting symptoms and ulcerous sections in various parts it is difficult to differentiate between different types of IBDs in which case the disease is named indeterminate colitis.
Piles or haemorrhoids are swellings that develop in and around the anal passage; can be temporary or permanent with mild to excruciating pain. The network of blood vessels that supply blood to the anal canal lining and adjoining parts enlarge when more than normal amount of blood gets engorged, which further give rise to smaller swollen nodes type of protruded mass. Piles can form mainly due to constipation that results in excessive pressure in the anal canal while emptying bowels, pregnancy wherein the growing uterus lays pressure on the ano-rectal part, age factor wherein the anal lining becomes less cushiony as a person grows older or due to heredity reasons. Haemorrhoids are classified into grades based on their size, location and severity.
Annually, there are over 7000 cases of anal cancer reported in America, of which almost 950 meet an unfortunate mortal fate within a few months of diagnosis. Anal cancer affects the anal tissues; once it becomes malignant the cancer cells invade the anal canal further. Anal cancers are uncommon in contrast to cancers of other organs, and become malignant in a majority of patients due to lack of onset of symptoms. Approximately 50% of anal cancer cases are detectable and treatable before they turn malignant. The overall 5-year survival prognosis is around 80% if the cancer is diagnosed early and has a higher incidence in women as compared to men. Anal cancer is more prominent in single men rather than married men due to association with multiple sexual partners, thereby increasing the likelihood of developing the disease due to infection by human papillomavirus (HPV) that causes genital warts. HIV positive individuals are also at a great risk of contracting the dreaded disease, often having a worse prognosis due to a greatly compromised immune system.
An anal abscess is a painful pus filled cavity, which develops as result of an infection and forms near the anal ano-rectal portion. 90% of the absecesses arise due to acute infection of the anal glands in the cryptoglandular epithelium, lining the anal canal. These pus filled cavities can infect various parts of the anus and rectum. The internal anal sphincter acts as a barricade between the lumen of the gut and the peri-rectal space, protecting from infection. Sometimes, the bacteria from the faecal mass or from other foreign sources block the cryptoglandular epithelium that in turn leads to pus formation in the anal and rectal tissues, later affecting the anal sphincter too. Based on the depth, severity and location, anal abscesses are divided into four types, named after the anatomical part they form cavity in. Perianal abscess is the most common type, formed below the anal skin, mostly visible from outside in the form of a swollen boil causing pain.
A medical intervention for a healthy gut!
In today’s modern stressful life, the medical dictionary is flooded with new terminologies, a lot of them are linked to some or the other types of digestive tract illnesses. Under such despairing circumstances, it is wise to make proactive health decisions than remain resistant to the idea to good health. Colonoscopy is one among several screening tests done to check for presence of cancer or polyps.
There are wide arrays of problems that affect the anal canal:-symptoms of which might include disorders either in the form of pain, redness, itchiness, loss of blood or lumps.
Haemorrhoids or piles are the most common condition of the anus, often unknown to the sufferer unless they experience any discomfort. Haemorrhoids are formed when the blood vessels in and around the anal and lower rectal regions enlarge during defecation, accompanied by blood in stool.
Haemorrhoids are commonly associated with piles, which many of us have but failed to notice in absence of any hitch. They are mass of tissues filled with blood vessels and muscles, cushiony in texture and appear in bunch in the anal canal. The problem starts when these haemorrhoids develop in size and become the seat of inflammation. In such cases, the clusters begin to enlarge and become inflamed and give rise to piles otherwise known as pathological haemorrhoids.
Anal fissure or ulcer of anus is generally a tiny cut in the anal lining that sometimes move up the canal; quite a universal condition equally prevalent among men and women of various ages. Fissures are painful, severe during passing stools. Among infants, bleeding of rectum is due to these anal fissures. Anal fissures occurs in anoderm that is specific tissue lining. Anoderm unlike normal skin is very sensitive without oil or sweat glands nor hairy growth and thus prone to easy pain due to wear and tear.
A fistula is an atypical link formed between two organs or structures as a result of some traumatic injury, previous botched surgery or even an infection. There can be a fistula formed between artery and vein, vagina and anus, uterus and peritoneum and at many other places. A fistula can be blind that has opening at one end, complete that opens inside and outside of the body, incomplete which is kind of tube closed inside the body without linking to other body part and finally a horseshoe shaped fistula that goes around one organ open outside the body and connect to another part. The horseshoe fistula is common in anal region.
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