Hemorrhoidal nodes are a frequent pest to people nowadays. They are composed of bags of blood vessels, connective tissue, and muscle fibers covered by the lining of the rectum and anal canal. These structures exist in every person and function to assist the anal sphincter in retaining gases and feces. Everything is fine until they become overgrows and develop complications.

We distinguish between internal and external hemorrhoids. Internal hemorrhoids are situated in the transition between the rectum and anal canal, and the external ones are situated between the anal canal and surrounding skin.

Many factors contribute to the appearance of hemorrhoids such as genetic predisposition, weakness of connective tissue and vascular walls, frequent and prolonged straining during bowel movements, constipation, chronic diarrhea, forced prolonged sitting in one place, and others. But in general it is important to understand that any increased abdominal pressure -- pregnancy and childbirth, certain liver diseases, constipation, chronic cough, urinary problems, and others may lead to aggravation of hemorrhoids. They were known as "the driver’s disease" twenty years ago due to time spent sitting in the car when traveling; today all modern professions associated with prolonged sitting suffer. They affect young people who sit on comfortable chairs in expensive suits all day.

The most common manifestations of the disease are pain, bleeding, itching in the anal area, spotting with blood and mucus, unusual throbbing in the anal area, and the feeling that bowel movements are incomplete.

The most common complications are bleeding, thrombosis, and entrapment of an internal hemorrhoid. Usually these are the symptoms that lead the patient to the surgeon. At the same time, many patients wrongly self-diagnose other maladies as hemorrhoids. It is not advisable to treat yourself alone. In very rare cases it is possible to overlook a possibly fatal disease. It is better to seek the help of a surgeon: surgery is one small option; problems can usually be solved with creams and medication. Surgery is performed only when complications are unresponsive to conservative treatments and worsen the quality of life of the patient.


An anal fissure is a wound caused by a rupture in the anal canal. It can be acute or chronic. An acute fissure occurs in the anal canal because of large hard stools and constipation, explosive diarrhea, injuries in the anus, anal sex, or after birth. Often, repeated ruptures and untreated acute fissures lead to development of chronic anal fissures. It may occur at any age, but is most common in women between 30 and 50 years old.

Patients complain of sharp, burning, throbbing, or dull pain in the anus, usually lasting for a period of a few minutes to a few hours after bowel movements. Bleeding occurs in most of these cases. It is minimal and usually seen on the toilet paper when wiping.

Acute fissures respond much better to conservative treatment, but recovery occurs after a period of at least three to four weeks of treatment, expressly provided that during this period the cause is not present. Chronic fissures respond poorly to medical treatment. Unfortunately, even surgical treatment is curative in only 90% of patients.

Acute fissures commonly involve outpatient procedures. The anal sphincter is dilated and medication is applied. If operation is necessary, it is done in a hospital setting.


Perianal fistula occurs when a passage develops between the anal canal in the tissue around the rectum and anus. The walls of the fistula are formed by granulation tissue, the result of prolonged inflammation. The inflammation is exacerbated constantly by incoming feces. Once formed, the fistula is maintained by chronic painful inflammation, resulting in secretions near the fistula opening. It is usually light in texture, like mucus with blood spotting.

The most common reason for the formation of fistulas is prolonged and untreated inflammatory originating from the tissues around the anus and rectum.

Perianal fistulas exhibit symptoms such as pain and discomfort in the anal area and periodically drainage of clear puss or bloody discharge from the opening to the anus or from the anus itself. When this hole is blocked, symptoms increase and may require emergency surgery. Acute condition can limit effectiveness.

It is namely these cases involving exacerbation with increased pain, fever, swelling and redness in the area that are subject to surgical treatment via emergency surgeries. Then, as with all pustules, the patient needs surgery for drainage. Drainage is required until the condition is cured, and after that, the fistula is likely to continue to exist and even develop complications
Perianal Abscess

The term “perianal” or “anorectal abscess” refers to a collection of pus in the tissues around the anus. It is believed that blockage of the anal glands caused by faeces or tissue trauma is what leads to infection of glandular ducts and the development of an abscess. The reasons for this can be constipation, not going to the bathroom on a long journey, or an immune deficiency. Abscesses can be small with limited inflammation or they can develop into life-threatening infections. Successful treatment depends on early diagnosis and adequate surgical treatment.

Symptoms of perianal abscess often begin with general pain in the anal area. Gradually it grows and becomes throbbing and localized in one specific place. The pain is increased with each bowel movement. Doctors can feel a painful swelling. The general condition of the patient worsens. It can lead to significant fever. Spontaneous popping of the abscess can cause leakage of pus and spotting, usually leading to relief. When the abscess is located in an elevated position, away from the skin, there may be no external manifestations of the disease for some time, except for complaints of fever, chills, general malaise, and immobilization.

The treatment of small abscesses can be done in urgent care, while larger ones can be treated in surgical wards not only by opening and clearing the collected pus in the abscess cavity but also through comprehensive treatment of the whole area. A wide range of intravenous antibiotics is also administered. Recovery depends on size, position, the stage at which treatment is initiated, and other factors.

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