Is Your Stomach Healthy? - Fisure & Fistulla

Raising Awareness on Anal Diseases People Hesitate to Talk About

Since this is Awareness Month for anorectal diseases, this week we explore the conditions that affect the anal canal — often misunderstood and left unspoken.

Not Secret or Shameful Diseases

Many people suffer silently from anal diseases, assuming there embarrassing or taboo. They hesitate to talk even to family or close friends. Its important to know that these are not secretive or sexually transmitted diseases — they are natural conditions that can affect anyone, regardless of age.

Knowing the types of anal diseases, available treatments, and where to get them is crucial. Lack of proper treatment at the right place can worsen the situation.

Structure of the Anal Canal

The anus acts like a gatekeeper — it opens to release stool and then closes again. This opening and closing action is managed by muscles (sphincters), nerves, and glands.

• External sphincter: Under voluntary control
• Internal sphincter: Works involuntarily

Because the anus is surrounded by sensitive nerves, diseases here are often painful. The glands present also help stool pass smoothly.

Types of Anal Diseases

Most people assume all anal issues are just piles (hemorrhoids), but in reality, other conditions like fissures and fistulas can also occur. Heres a breakdown:

1. Hemorrhoids (Piles)

One of the most common anal diseases, mainly caused by:

• Lack of fiber in the diet
• Straining during bowel movements
• Chronic constipation

Hard stools cause veins in the anus to swell and bulge. Initially, internal hemorrhoids are not painful but may bleed. Over time, they may protrude outside the anus, becoming external hemorrhoids.

Symptoms include:

• Bleeding during defecation (painless)
• Feeling of small lumps at the anus
• No pain unless the condition progresses

Treatment:

• High-fiber diet
• Medications to strengthen veins
• Sitz baths and ointments
• Advanced cases may require surgery

Modern surgical methods (Laser, Stapler, Banding) are painless, bloodless, and enable quick recovery.

2. Anal Fissure

Even more common than hemorrhoids, affecting all age groups.

Caused by:

• Constipation
• Hard stools causing a tear in the anal lining

Symptoms:

• Sharp pain during and after bowel movements
• Bleeding
• Confused with piles due to similar appearance

Though the cause overlaps with piles, treatment is different. Medical treatments (ointments to increase blood flow, stool softeners) are often effective. Surgery is considered if these fail.

3. Anal Fistula

This is the condition that frightens patients the most.

Fistulas are abnormal tracts formed due to infections in anal glands. If the anus isnot cleaned properly, blocked glands can become infected and burst — forming tracts that ooze pus or blood and cause recurring pain.

Treatment:

• Medical therapy is usually not effective
• Surgery is necessary

Doctors use advanced techniques like:

• NAFFT (Endoscopic procedures)
• LIFT (Ligation of Intersphincteric Fistula Tract)

These are tailored based on the length, path, and branching of the fistula tract.

Does Surgery Affect Bowel Control?

Many fear that surgery may impair control over bowel movements. This is not true when done by trained surgeons using modern tools like MRI, CT, and endoscopy to map the condition precisely. These ensure preservation of sphincter muscles and normal function post-surgery.

Prevention and Awareness

Prevention tips:

• High-fiber diet
• Prevent constipation
• Keep the anal area clean

When diseases do occur, its important to:

• Identify the correct type
• Seek proper treatment
• Avoid suffering in silence due to shame