Ano-Rectal Clinic

Ano-Rectal Clinic

Ano-Rectal Clinic

Our endoscopy unit is the largest independent endoscopy unit in Scotland and has excellent results in terms of quality of procedure, patient satisfaction and outcomes.

Diseases of the anus and rectum are common and in most cases are not serious.  However, these can be embarrassing, and people tend not to deal with their symptoms in a timely manner.  The primary symptoms of rectal bleeding, pain, incontinence and perianal itch are frequently distressing.  In a small number of patients these symptoms may be the first signs of serious underlying diseases such as inflammatory bowel disease or cancer.  

Our specialist endoscopy allows us to proceed directly to an examination of the back passage and the lining of the bowel.  This can be performed at the same visit so there is no waiting around for appointments and results are imminent.

Our endoscopy unit is the largest independent endoscopy unit in Scotland and has excellent results in terms of quality of procedure, patient satisfaction and outcomes. 

  • Rectal bleeding 
  • Anal/rectal pain
  • Incontinence
  • Perianal itch 

CONDITIONS THAT CAN CAUSE SYMPTOMS INCLUDE THE FOLLOWING:

Haemorrhoids are the commonest cause of rectal bleeding, itching and occasional discomfort.  They affect about half of the adult population in the UK at some time in their life.  Haemorrhoids occur when blood vessels in the anal canal become engorged and swollen.  This can occur for no apparent reason but is more common in any condition that increases pressure in the veins of the anus, such as childbirth, straining and constipation. 

An anal fissure is a crack in the skin at the anus and often results from straining to pass stools.  The symptoms are often fresh bleeding (similar to haemorrhoids) but a fissure is usually associated with pain – particularly after a bowel motion.

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.

In a small number of patients’, the symptoms of rectal bleeding, discharge and pain are due to diseases within the bowel such as ulcerative colitis, Crohn’s Disease or cancer. It is therefore very important not to ignore these symptoms and to get the most appropriate investigations. Should you have ongoing issues with an of the conditions above that are causing you pain or discomfort or if any of the symptoms above are familiar to you, we would strongly advise having these reviewed at one of our clinics. If your symptoms are severe, we would strongly advise you visit your GP, call NHS 24 or visit your nearest A&E department