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Modern Treatment of Anorectal Diseases

 

I have anal fistula. I have taken various medicines prescribed by alternative medical practitioners but it has not healed. I am scared of surgery since I have heard it is painful and fail most often.

Anal fistulas can be cured only by surgery. So don’t waste time and money on pills and creams. The fistula surgery has improved in recent times due to better MRI scans, techniques like VAAFT, LIFT, Seton and Plug for complex cases. Most cases can be sent home after a single day hospital stay with minimal pain and wound. The failure rate for a simple fistula is rare and 15% for complex fistulas. Also in traditional surgery there is a chance of damage to anal muscle that can lead to inability to hold stool. This is least likely in modern surgery.

 

I am suffering from Piles since last 2 years and I have taken various alternative medicines but if I stop taking these, the problem starts within 2-3 days. How long do I have to take this?  Do I need surgery?

Most alternative medicines have no scientific basis or evidence. On the basis of scientific evidence, if there are smaller piles (grades one or two) they may benefit from injection or banding treatment. If you have grade three piles (piles that come out of the anus and bleed profusely), you need surgery. Surgery can be open or stapler. I recommend stapler since there is no pain or wound after the operation. It does not require any dressings and patients can return to their work within a day or two. If I needed surgery I would (having done both types of operation extensively) choose staplers any time.

 

I have pain when I pass stool for years. What should I do?

You should see a doctor immediately since it can be due to a simple correctable cause such as an anal fissure or it may be due to a sinister cause such as a rectal cancer.

A simple day care surgery can cure anal fissure forever.

 

My rectum pops out of my anus when I pass stool (Rectal prolapse). What is the modern treatment for this disease?

This popping out of rectum on straining for defecation is called rectal prolapse. If not treated early, these patients will develop permanent damage to their anal sphincter and may lose ability to control their passage of stool. Nowadays rectal prolapse can be treated by laparoscopic surgery without the need for cutting the abdomen. This means less pain, less wound and a hospital stay of 2-3 days only.

 

What is the recent advancement in the management of cancers of colon and rectum?

Early detection and surgery is the key to a successful management of these patients. The surgery can nowadays be done by laparoscopy and hence the patients are spared the trauma of open long incisions.

The combination of radiotherapy in rectal cancer and chemotherapy in colon cancer has improved outcomes too.

Watch the video of Anorectal Surgery on YouTube.