DR. MED. STEPHAN POTZLER

Therapy

Therapy

 

With the exception of the well-known forms of cancer such as prostate and breast cancer, colorectal cancer is the most common form of cancer among men and women; and this although preventive measures are both extremely easy to carry out and very effective. The examination itself takes the form of an inspection of the anus and the rectum (proctoscopy/rectoscopy). Depending on the individual risk profile, a full colonoscopy may be recommended. A proctological check-up should be carried out at least once a year. A repeated colonoscopy may be required, depending on the diagnostic findings. In general, all examinations and treatments are pain-free.

 

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Acuminate warts (or pointed condyloma) are a sexually transmitted viral disorder. The warts, which occur on the skin of the anus and in the anal canal, often spread rapidly and can grow considerably with time. Itching and weeping are also experienced at the anus. Very careful treatment and aftercare are essential in order to prevent a recurrence.

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An anal abscess is a tissue cavity filled with pus. In most cases this is the final stage of a long-term fistula. Rapid treatment and operative exposure are necessary.

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Anal eczema is the medical term for inflammations of the skin around the anus. It is often caused by changes in the anal canal and rectum due to problems such as enlarged haemorrhoids or rectal prolapse. Factors such as metabolic disorders, parasites or fungal diseases can also be responsible.

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In an anal fissure the skin of the lower anal canal is injured, which may affect the inner sphincter muscle and will lead to heavy pain and the passage of bright red blood.

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Anal fistulas are inflamed tubes filled with pus, usually beginning in the area where the rectum joins the anus. They often form over longer periods of time and can lead to the formation of an abscess. The treatment depends on the course followed by the fistula through the sphincter muscle and also on any other illnesses already present. In most cases an operation has to be carried out under general anaesthetic to expose the area. This is necessary to prevent irreparable damage to the sphincter muscle and all other tissues.

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A so-called anal or perianal thrombosis (also incorrectly known as “external haemorrhoids”) is caused by a torn vein at the edge of the anus. Blood deposits under the skin of the anus, which could lead to considerable pain. The causes range from straining at stool to inflammations of the intestine. These structures can often reach the size of a plum. In such cases they are removed under local anaesthetic. Smaller thromboses do not require an operation but can be treated with bowel movement regulation and ointments.

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Chronic inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis are very complex disorders requiring close cooperation between different medical specialists because the symptoms are very varied and are expressed to different extents. They often involve frequent motions with mucus and blood and corresponding pain in the whole abdominal cavity.

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Colorectal polyps are changes in the intestinal wall that can lead to cancer of the large intestine. They generally grow very slowly. Special stool tests carried out regularly can help to identify them early enough. A colonoscopy can also be performed. From a certain age, which depends on the individual profile, regular checkups should be carried out. This is currently seen as the easiest way to detect intestinal cancer at an early stage so that it can be successfully treated.

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Digestive disorders include the well known problems of severe constipation (obstipation) and diarrhoea. These can result in deficiency symptoms in the body’s metabolic cycle. The causes are very varied and range from an unfavourable diet as a result of specific lifestyles, or underlying illnesses such as thyroid malfunction or heart disease, to certain medications.

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Haemorrhoids are, in themselves, normal blood vessel cushions that are found in the rectum about 5cm from the edge of the anus. Their function is to act as a seal which, among other things, prevents the involuntary release of stool. If, under particular conditions, the haemorrhoids become permanently swollen, they can result in symptoms such as itching, weeping, burning or bleeding. If they are not treated, they can lead to a weakness of stool control or even incontinence of stool.

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Intestinal mycoses and parasites cause a variety of symptoms, which can also affect other vital organs. The first signs are often intense itching and weeping at the anus.

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Irritable bowel syndrome is often a collection of symptoms such as stomach cramps, varying stool incontinence, pronounced wind and intolerance of certain foods.

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Mariscas are flaps of skin at the edge of the anus with varying sizes. They often follow an inflammation in the anal area and are removed under local anaesthetic.

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Metabolic disorders can cause considerable symptoms, particularly in the large intestine area and other organs. Thorough investigation and diagnosis of the possible causes is necessary.

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Pain in the anal and pelvic area can have very different causes. Sudden shooting cramp-like pains often occur which can last for several minutes or, rarely, up to several hours. The causes include anal tears and falls onto the coccyx. In most cases rapid relief can be achieved by using cramp-relieving suppositories or particular relaxation techniques. Additional investigation and precise diagnosis is necessary.

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Pelvic floor disorders involve weakness of the musculature and ligaments of the lesser pelvis. Both men and women can be affected. These disorders are often associated with a functional disturbance of bladder and bowel emptying.

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Rectal prolapseall is a turning inside-out of the intestinal wall. The intestinal tissue protrudes into the anal area and out through the anus, often causing an urge to defaecate without the corresponding motion. An operation is often the only available treatment option.

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There are two types of sphincter muscle malfunction . One type involves a change in the strength of the muscle and the other is due to a disturbance of nerve conduction. They can be caused by frequent straining at stool, greatly enlarged haemorrhoids, rectal prolapse or repeated inflammations of the rectal area. The symptoms often begin with weeping and stool smearing followed by an inflammation of the anal skin. If left untreated for longer periods, this problem leads to incontinence. Depending on the degree of severity of the problem, appropriate treatment can restore normal functioning of the sphincter muscle. Only in a few cases is a corrective operation necessary.

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Stool incontinence is a consequence of advanced weakness of the sphincter muscle. The patient becomes unable to hold back the motion so that it is released involuntarily and prematurely. Usually several disorders are involved. These range from long-term inflammation of the large intestine to dislocation of the bony sacrum (e.g. after a fall) with resulting disturbance of nerve pathways.

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