An abscess is a collection of pus in any localised space in the body. An anal abscess is one that develops in the tissues around the anus. Treatment requires draining the pus from the abscess cavity by making an opening through the overlying skin. This may be done under local anaesthesia or may require wider drainage, under general anaesthesia. Hospital admission is needed for such a procedure. Antibiotics may be used to control the spread of the infection, but antibiotics alone will not cure an abscess.
An anal fistula is an abnormal track ("tunnel") between the internal lining of the anus and the skin outside the anus. A fistula may develop after drainage of an anal abscess but may occur spontaneously. Discharge of pus may be constant or intermittent as the external opening on the skin may heal temporarily. Surgery is needed to cure a fistula. The course of the track between the anus and the skin has to be identified and exposed. This track may be treated in one of three ways according to its complexity. Most operations for fistulae are performed in hospital but small fistulae can be managed in Day Care Centres.
A fissure is initiated by a small split in the lower third of the anal canal. This split fails to heal and becomes established as a painful longitudinal ulcer associated with spasm of the anal sphincter muscle. Most acute superficial fissures heal spontaneously, and even deep chronic fissures can heal with conservative measures. Management includes ensuring soft stools by maintaining a high dietary fibre and fluid intake and careful anal hygiene to keep the fissure clean. The surgical treatment of an anal fissure can usually be performed as a day procedure with minimal hospital stay.
Haemorrhoids are often described as "varicose veins" of the anal canal. In fact they consist of various engorged blood vessels covered by lining of the anal canal. Mild symptoms can frequently be relieved by increasing fibre and fluids in the diet and avoiding excessive straining. Local ointments are of limited value but may give some relief. Surgical excision is sometimes necessary to treat large or complicated haemorrhoids. The procedure is performed under anaesthesia. The operation may be conducted in hospital or in a day care centre.
A hernia is the protrusion of tissue and / or organs through a weakened part of the abdominal wall. If left untreated, the split in the muscle widens and greater amounts of tissue and / or organs are pushed through the opening causing a visible lump or bulge. Hernias require surgical repair as if left untreated, can lead to serious complications. Approximately 40,000 Australians have their hernias surgically repaired every year.
Gallstones are ‘stones’ that form in your gallbladder. For some people gallstones can cause severe symptoms, with repeated attacks of abdominal pain being the most common. It is possible to dissolve the stones or even shatter them into small pieces but these techniques involve unpleasant drugs that have side effects and a high failure rate. They will not cure the condition and symptoms are likely to come back.
Laparoscopic cholecystectomy is the treatment of choice for most patients who need their gallbladder removed. It involves several (usually four) very small incisions to separate and remove the gallbladder. In some situations due to unexpended findings or events, a gallbladder cannot be removed laparoscopically and may have to removed through a larger incision (open surgery) for the safety of the patient. This conversion happens in about 5% of cases.
Any surgical or invasive procedure carries risks. The information provided here is for general educational purposes only. Before proceeding, you should discuss your individual situation and treatment options with Dr Pincott.