CONDITIONS

ANAL CONDITIONS

ANAL ABSCESS

An anal abscess results when a perianal gland becomes infected. It causes severe pain in the region around the anus. There may also be discharge of pus or blood from the anus with an offensive odour.
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ANAL CANCER

Anal cancer is a skin cancer that arises from inside the anal canal or from the skin around the anus (anal verge).
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ANAL FISSURES

An anal fissure is a tear or split in the lining of the anus (anal mucosa). This if often due to constipation with firm stools tearing the mucosa on defecation. Anal fissures result in severe pain on defecation, with anal sphincter spasm, and further tearing. This often leads to the avoidance of defecation, establishing a vicious cycle of
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ANAL FISTULA

An anal fistula is a communicating tract between the inner anus or rectum and the external skin surrounding the anus. It begins as a superficial ulcer (Figure 1), that becomes infected creating an anal abscess that subsequently bursts leaving a communicating tract between the internal anus and the external skin of the perianal region. It
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ANAL PAIN

Pain from the anal region can cause a lot of concern, as it is an unusual experience. The nature of the pain can often be a clue as to the underlying cause however referral to a colorectal surgeon to properly investigate this condition may be indicated.
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ANAL PRURITUS

Anal pruritus (also known as “pruritus ani”) is persistent itching of the skin around the anus. This desire to itch can be further exacerbated by increases in moisture, pressure, and rubbing caused by clothing and sitting. It is a benign condition but can cause intolerable discomfort. Regardless of cause, the problem is exacerbated by a self
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ANAL WARTS

Anal warts (also called Condyloma Acuminata) result from previous infection with the Human Papilloma Virus (HPV).
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HAMEORRHOIDS

Internal haemorrhoids are vascular structures inside the anal canal which help with stool control. Normally they act as cushions that provide a water and air-tight seal preventing incontinence. When they become enlarged, the can bleed, or cause pain, or occasionally fall outside the anus (prolapse), sometimes to the point where they will not
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ADJUVENT THERAPY

CHEMOTHERAPY

Chemotherapy might be necessary following colorectal cancer surgery if there is local spread to lymph nodes. This is typically given over 6 months.
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RADIOTHERAPY

Radiotherapy is often given for anal cancers and advanced rectal cancers.
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COLORECTAL CANCER

Colorectal cancer is the commonest cancer in Australia. Most colorectal cancer, if picked up early, can be cured with surgery alone, with a better prognosis than most other cancers
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CONSTIPATION

Constipation is a symptom that means different things to different people. Most commonly, it refers to infrequent bowel movements, but it can also refer to increased firmness of stool, the need to strain to pass a motion, and a sense of incomplete evacuation, or the need for laxatives, suppositories or enemas to maintain regularity.
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IRRITABLE BOWEL SYNDROME

Irritable bowel syndrome (IBS) refers to a disorder that involves abdominal pain and cramping, as well as changes in bowel movements. It is not the same as inflammatory bowel disease (IBD), which includes Crohn’s disease and
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SLOW TRANSIT CONSTIPATION

Slow transit constipation (STC) typically involves the unusually slow passage of faeces through the colon (large intestine). This can lead to chronic constipation and uncontrollable soiling. STC may mimic or coincide with
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IBD

CROHN’S DISEASE

Crohn’s disease, is an inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract (GIT) from mouth to anus, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhoea (which can be bloody when inflammation is uncontrolled), vomiting, and can also cause complications outside the GIT such as skin
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ULCERATIVE COLITIS

Ulcerative colitis is a form of inflammatory bowel disease (IBD) that results in inflammation of the rectum and colon. It is not common, occurring in 5 per 100,000 of the Australian population. It most commonly has its onset in
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DIVERTICULAR DISEASE

Diverticular disease of the colon is where “pockets” occur at weaknesses in the colon wall. These pockets are called diverticula. These pockets typically occur in the last part of the colon before reaching the rectum (the sigmoid colon). When one or more of these diverticula rupture it results in inflammation or infection of the involved colon
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ENDOMETRIOSIS

5-15% of women with endometriosis have colonic or rectal involvement [1]. Usually only the outside wall of the colon or rectum is involved. Occasionally the endometrial deposits are much deeper within the recto-vaginal septum.
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FAECAL INCONTINENCE

Faecal incontinence may be due to central or peripheral causes. Peripheral causes include those due to a weak pelvic floor, a weak or injured anal sphincter or impaired nerve supply to the sphincter (pudendal neuropathy). These all require investigation, with significant improvement in continence frequently achieved with a combination of
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FAECAL OCCULT BLOOD (FOB)

Faecal occult blood (FOB) refers to blood in the stool (faeces) that is not visible. A faecal occult blood test (FOBT) checks for this blood by smearing faeces on a test strip.
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GENETIC SYNDROMES

Six percent of colorectal cancers are due to inherited genetic syndromes. These genetic syndromes typically increase the risk of developing polyps. The most common of these genetic syndromes is Lynch Syndrome (also called Hereditary Non-Polypsosis Colorectal Cancer). Patients with Lynch syndrome are particularly at risk adenomatous polyps as well
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HERNIAS

GROIN HERNIAS

Groin hernias can be repaired as a day-stay procedure using an open or key-hole (laparoscopic) approach. Open repair can be performed under local anaesthetic with sedation, whereas key-hole (laparoscopic) repair requires a general
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INCISIONAL HERNIAS

Abdominal incisional hernias are common after operations requiring a large incision. These can be at the umbilicus, above the umbilicus (epigastric) or along the full length of the incision (massive ventral hernia)
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STOMAL HERNIAS

A stomal hernia (also called a para-stomal hernia) is a type of incisional hernia that occurs next to a stoma. It is a common problem, and can be challenging to manage.
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INTESTINAL FAILURE

Intestinal failure is where the intestine is shorter than normal and fails to absorb sufficient nutrients to maintain the body’s nutritional needs. It often results from multiple previous bowel resections, and typically
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PILONIDAL SINUS

Pilonidal sinus results from hair being forced beneath the skin through a midline dimple in the cleft region between the buttocks.
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POLYPS

A polyp is an abnormal growth or projection from the mucosal surface or lining of the bowel wall. A polyp typically has the appearance of a small, warty outgrowth.
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RECTAL CONDITIONS

RECTAL BLEEDING

Rectal’ bleeding (hematochezia) refers to the passage of red blood from the anus, often mixed with stools and/or blood clots. It is called ‘rectal’ bleeding because the rectum lies immediately above the anus, and although the bleeding may be coming from the rectum, it may also be coming from higher up in the gastrointestinal tract (GIT).
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PROCTITIS

Proctitis is inflammation of the lining (mucosa) of the rectum.
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RECTAL PROLAPSE

Rectal prolapse describes a condition where either the lining or entire wall of the rectum becomes loose and falls into the rectum, or even out of the rectum through the anus.
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STOMAS

A stoma is where intestine is brought out on the anterior abdominal wall to divert faeces, so that faeces no longer pass through the anus. A stoma appliance bag is applied to the stoma to prevent soiling.
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