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Fissures And Piles – Common Anal Problems For The Youth

By Dr Govind Nandakumar
| Reviewed By Govind Nandakumar

Pain in the "ass" is a colloquial term that does have some science to it!

Anal pain is one of the most common complaints that patients present with.

Patients are often scared and embarrassed to seek attention and try various local remedies that don't really work.

Anal Pain Due To These Causes:

Anal fissure is a tear in the skin because of a hard bowel movement and tight muscles.

Haemorrhoids (Piles), generally external haemorrhoids, are blood vessel complexes that can harbour a clot and cause pain occasionally, which develops into an infection.

Abscess or fistula are glands in the anus that give rise to a local "pimple" that can enlarge and cause an extreme amount of pain.

Rarely, other infections and cancers can cause anorectal pain as well.

Nevertheless, anorectal pain requires a visit to a qualified proctologist.

Early appropriate attention can prevent unnecessary complications from some of the conditions mentioned above.

Some of these conditions can be treated easily and other warrant a more thorough evaluation of the colon, rectum and anus sometimes with a colonoscopy.

This is especially true for elderly patients in whom the risk of a secondary process like cancer is higher.

Common cause of anal pain for young patients is fissure, abscess and piles. Fissures occur after a hard bowel movement across a tight internal anal sphincter.

First-line therapy consists of stool-bulking agents (psyllium husk, isabgol) increased hydration and a calcium-channel blocker cream to relax the anal sphincter.

Second-line therapies for severe cases require surgery to relax the sphincter.

Majority of haemorrhoids don't require surgery! They are a normal part of everyone's anal canal and require intervention only where they cause symptoms.
Don't be in haste to have your haemorrhoids banded or removed, it's unnecessary!

First-line treatment consists of increasing fibre and water intake. Most of the local creams don't work! A visit to a qualified surgeon may be required if you have persistent symptoms.

A perianal abscess or fistula requires the attention of a qualified surgeon to evaluate the area and come up with a good treatment plan.

Also Read: Ayurvedic Treatment For Piles

Unfortunately, patients are misled by common catch phrases like "laser" "glue" or "plug". These modalities have little, if any, proven role in the management of complex anorectal abscesses or fistula.

We now have a variety of novel surgical procedures that have been rigorously studied and can be tailored for complex fistulae.

Another common thing about anorectal complaints is itching. Itching in the area can be from improper cleaning habits, skin irritation, infections or a secondary process.

Certainly, this requires to be evaluated by a qualified surgeon and worked upon.

Keep your rectal region healthy by ensuring a well-balanced high-fibre diet with plenty of water.

The American Society of Colon and Rectal Surgery recommends about 30 grams of fibre to be included in a day. A difficult target to reach with modern diet and lifestyle! Nevertheless, high-fibre foods will keep your colon and rectum healthy!

Govind NandakumarGastrointestinal Surgeon
MD, Residency in General Surgery
Govind Nandakumar