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Gastrointestinal Home Page
Health Information
Division of
Gastrointestinal Surgery
Anorectal Disease
Dr. Allen Bar
Dr. Bar
Steven Raper
Dr. Raper
Ian Soriano
I. Soriano
Noel Williams
Dr. Williams

Anorectal disease pertains to those illnesses located in the anal and rectal portions of the large intestine. The most common diseases are:

Hemorrhoids Anal Fissure
Anorectal Abscess Anal Fistula

hemorroidHemorrhoids are large, saclike blood vessels similar to varicose veins located in and around the anus (the opening of the anal canal) and lower rectum (the portion of the large intestine just proximal to the anal canal).

Some contributing factors to hemorrhoids are aging, chronic constipation or diarrhea and pregnancy.

Most hemorrhoidal symptoms respond to non-surgical treatment such as increasing intake of dietary fiber and avoiding predisposing conditions such as constipation.

Surgical treatment is indicated for patients who continue to have severe bleeding, pain or protrusion despite good medical treatment. The most common surgical treatments for severe hemorrhoids are rubber band ligation and hemorrhoidectomy. The rubber band ligation procedure can be performed by a surgeon as an outpatient procedure.

Surgery to remove hemorrhoids -- the hemorrhoidectomy -- is the best method for permanent removal of hemorrhoids. This procedure is usually performed as an outpatient but may require hospitalization and a period of inactivity.

An Anal Fissure is a small tear in the lining of the anus which causes pain, bleeding and itching.

Anal fissures are frequently caused by hard, dry bowel movements, diarrhea and inflammation in the anorectal area.

Most fissures heal spontaneously or with non-surgical treatments such as medicated creams and topical ointments.

When surgical treatment of fissures is required it can usually be performed without an overnight hospital stay. Surgical repair -- an internal sphincterotomy -- consists of a small operation to relieve the underlying muscle spasm which contributes to the fissure.

In most cases, pain disappears after a few days and complete healing occurs in a few weeks.

An Anorectal Abscess is an infected cavity filled with pus found near the anus (the opening of the anal canal) or rectum (the portion of large intestine just proximal to the anal canal). The abscess results when bacteria or fecal matter enters the tissue outside the anal through infected anal glands from within the anal canal.

An Anal Fistula is a small, abnormal tunnel connecting the anal glands from which abscesses originate to the skin of the buttocks outside the anus. Inflammatory bowel diseases such as Crohn's disease and colitis increase the likelihood of anal abscesses and fistulas.

Symptoms of both ailments include constant pain, skin irritation around the anus, pus drainage, fever and swelling.

An anal abscess is treated by surgically draining pus from the infected cavity and making an opening in the skin near the anus to relieve pressure. This procedure is usually done on an outpatient basis. Fistulotomy -- surgical treatment to cure an anal fistula -- can be performed on an outpatient basis as well or with a short hospital stay.

Inpatient Facilities:
Hospital University of Pennsylvania (HUP)
Penn Presbyterian Medical Center (PPMC)
Pennsylvania Hospital (PAH)

Office Visit Locations:
Perelman Center - West Pavilion, 4th Floor (HUP)
266 Wright-Saunders Building (PPMC)
700 Spruce Street - Garfield Duncan Building (PAH)

Making an Office Visit Appointment:
215-662-2626 or 800-789-PENN

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