Symptoms for haemorrhoid disease are oozing, itching, blood on the bowel movements, sometimes pain and prolapse. These symptoms can be misleading to other condiotions like anal thrombosis, fissure, fistula, abscess or even malignant tumors.

Haemorroids are very frequent and can be treated gently and conservatively, especially in early stages. In advanced stages (grade 3 and 4) operations are mostly recommended. In these cases recent proceedings offer atraumatic options, like RAR, recto-anal-repair (ultrasound guided haemorrhoidal artery ligation with mucopexy).

Anal Fissure

Painful tears of the anal skin and/or the rectal mucosa can be treated conservatively with ointments, when they are still fresh and acute.

Sometimes Botox helps to relax the thight and spastic anal sphincter muscle. In advanced cases the fissure turns into a chronic inflammatory ulcer, wich may need to be removed by operation.

Anal Abscess and Fistula

An abscess in the perianal region is often caused by an anal fistula.

Fistulas develop from anal glands and get either infected acutely (abscess) or lead to an oozing hole next to the anus.

The extension of fistulas vary among patients and there are different options in the treatment of fistulas. To treat them correctly, it is crucial to examine exactly the local dimensions of the individual fistula in the individual patient in order to prevent complications and recurrence.

Anal Thrombosis and Anal Piles and Warts

Blood clots in the perianal veins occur often after pressing hard with bowel movements or lifting heavy weights (i.e. high pressure on the pelvic floor).

They are recognized by tender lumps next to the anus and can be painful.

Sometimes they burst and bleed. Anal thrombosis often resolve spontaneously leaving anal piles (i.e. skin tags). When they are big, they should be removed.

Anal warts are mostly sexually transmitted and can be treated conservatively in early stages. If hard lumbs occur, operation is sensible.