What are rectal polyps?
Intestinal polyps represent a rather common clinical picture. Only approx. 7% of the people notice any unusual growth. It concerns primarily benign tumors of the mucous membrane which reaches into the intestinal area. Polyps primarily affect people at an older age. The significance of these polyps is that they can eventually become cancerous. Therefore it is absolutely necessary to remove these polyps.
Does the patient feel pain of discomfort?
60% of the patients have absolutely no discomfort. Polyps are detected by chance, i. e. during endoscopic colon examination. Large polyps can sometimes cause discomfort. The patients report mucus discharge, bleeding, rectal tenesmus or occasional pain.
How are polyps diagnosed?
The doctor can detect polyps during an endoscopic examination. Bloody feces as well as mucus membrane discharge would raise suspicion of intestinal disease. In this particular case a colonoscopy with a rigid or flexible endoscope are strongly recommended to exclude malignancy.
Which treatment methods are possible?
Each polyp has to be removed and microscopically examined for malignancy. The polyp is being removed with little pain during a colonoscopy with an electric loop.
What are hemorrhoids?
Hemorrhoids are a vessel disease in the rectum area. They are caused by knotty enlargements of vessel pads which are located above the sphincter within the mucosa. They are spongy bodies, supplied with arterial blood. As soon as they reach a certain size it is possible for them to exit through the rectum opening.
Does the patient feel any discomfort?
Itching and burning in the rectal area can be the first signs of hemorrhoids. Additionally, the feeling of foreign objects in the rectum, wetness and mucus membrane discharge can add to the discomfort. At an advanced stage, due to the arterial blood supply light red bleeding can incur which may become heavy at times. At the late stage, the hemorrhoids are clearly visible, extremely painful and located as bluish protrusions outside the sphincter; they cannot be moved back into the rectum. It is important to remember that the symptoms of potential hemorrhoids could hide an undetected malignant rectal tumor, since the initial symptoms are the same as with hemorrhoids. In any case, the suspicion of malignancy has to be eliminated.
What are the causes?
The main cause is usually an inherited connective tissue adynamia. Aiding factors are constipation, heavy pressing during bowel movements, low fiber diets, pregnancy, increased sitting and standing. 70% of adults over the age of 30 suffer with this disease.
Which treatment possibilities are available?
The basic treatments are regular bowel movement, high fiber diet and exercise. Constipation and heavy pressing during bowel movements should be avoided at all costs. Laxatives should only be used in isolated cases and on a short term basis. The therapeutic spectrum includes, according to size and extension of the disease, obliteration, rubber band ligature or the surgical removal of one or more hemorrhoidal knots. According to the stage of the dis-ease, various therapies are possible and all are available at our hospital.
With the HAL/RAR therapy an ultrasound detector (Doppler) is inserted deep into the rectum whand can exactly detect the location of the hemorrhoid artery and make it audible to the doctor via “sibilant sound”. Afterwards these vessels can be precisely injected and with the help of a special proctoscope inhibited by thread. After one to two weeks the hemorrhoids start to shrink due to the cut-off blood supply. In order to enhance this method, the HAL method is combined with the RAR method, which additionally includes the shortening of the mucous membrane. Since this treatment happens outside the algesic area, little or no pain is felt afterwards. Merely a feel of pressure is being reported.
Most patients can be symptom free after just one treatment which lasts approx. 20 – 30 minutes. It is our experience that only very few patients need two treatments to remedy the hemorrhoid problem of which, according to statistics, every 3rd German is afflicted.
What is an Anal Fissure?
It involves an extremely painful lengthwise tear in the rectal tissue.
What does the patient experience?
During and after bowel movements the patient experiences continued burning pain. Sometimes a little bleeding can occur. The tear can easily become infected due to stool residue.
What are the Causes?
Increased strain of the sphincter muscle leads to a blood flow restriction in this area. Together with the lack of an arterial vessel it leads to circulatory disorders and the healing process is prevented
At the same time, the increased muscle tone is being sustained by the pain and further increased. The existing infection can therefore change from an acute to a chronic state. The condition is promoted by hard bowel movements as well as constipation. Occasionally can a chronic inflammatory bowel disease hide the so called Morbus Crohn syndrome.
Which treatments are available?
With acute anal fissures the treatment by local injections with a long term anesthetic has proven to be beneficiary, so have suppositories, crèmes and ointments. The ingredients are meant to improve blood flow and reduce the sphincter pressure for the new tissue to occlude the defect.