Ano-Rectal Clinic

A perianal haematoma is a blood clot in the skin around the back passage.  As for fissures and haemorrhoids it is usually caused by straining to pass a stool.  Most people complain of a pain at the back passage and are aware of a lump.  Over the course of a week the pain usually subsides but the lump may remain.

A peri-anal abscess is a contained collection of pus under the skin in the area of the anus.  It may relate to a previous fissure, an infection in a hair follicle or from an infection inside the anus/rectum.

Abscesses are usually very painful and may be associated with a temperature and feeling generally unwell.  These require urgent treatment in the form of an operation to drain the pus.  They will not get better with antibiotics alone.

A fistula-in-ano is a connection between the inside of the anus/rectum and the skin.  It usually develops as a result of an infection of one of the small glands in the anus which discharges through the skin. However, fistulae can result from: Crohns Disease, fissures and previous surgery.

The symptoms of a fistula can include: 

• Skin irritation around the anus due to discharge 
• A constant, throbbing pain 
• Smelling discharge from near your anus
• Difficulty controlling bowel movements (usually in cases of long-standing problems).

The end of the fistula might be visible as a hole in the skin near your anus, although this may be difficult for you to see yourself.  Fistulae can lead to the development of abscess and treatment is surgery to drain the fistula. 

A rectal prolapse occurs when the rectum (the lowest part of the bowel) protrudes out through the anus.  It is a condition that usually results from weakness in the muscles of the pelvic floor and is most commonly related to multiple childbirths, injury during child birth and straining.  As might be expected rectal prolapse is more common in women than men and may be associated with other forms of prolapse in women (uterine prolapse and/or prolapse of the bladder). 
 
Rectal prolapse may be associated with a constant feeling of pressure or ‘something falling down’.  It can cause bleeding and incontinence or may be relatively asymptomatic.  Similarly, a prolapse can cause constant symptoms or only very occasional symptoms.  The treatment is very dependent upon how much of a problem the prolapse is to each individual.

A polyp is a growth in the lining of the bowel with protrudes into the lumen of the bowel.  At first these are very small but can grow quite large.  Small polyps do not usually cause any symptoms but as they get bigger may bleed.  Polyps close to the lower part of the bowel may produce mucous – seen as a slimy discharge and may cause a feeling of incomplete evacuation of stool. 
 
It is only a small number of polyps that result in symptoms.  For most of these, the reason to remove them is the risk that if left some polyps become cancerous. 
 
Polyps are usually removed at the time of a colonoscopy or sigmoidoscopy and then sent to the laboratory to determine the risk of them becoming cancerous. The important thing is though is that removing a polyp potentially stops a cancer developing.Rectal prolapse may be associated with a constant feeling of pressure or ‘something falling down’.  It can cause bleeding and incontinence or may be relatively asymptomatic.  Similarly, a prolapse can cause constant symptoms or only very occasional symptoms.  The treatment is very dependent upon how much of a problem the prolapse is to each individual.