Rectal-Anal Disorders: Rectal Prolapse And Anorectal Abscess

Rectum and anal disorders are the most annoying and painful affections of human body. The sufferings induced by diseases of these organs are intense. They can be local or involve other adjacent organs. These affliction leads to disturbance of mind and body. Person is unable to perform his regular duties.

Anus is the oval orifice through which stool is evacuated out of the body. Rectum is a tube like structure before anal opening. Stool is held in rectum before it is excreted out from the anal canal. Below are mentioned several disorders of anus and rectum.

Some of the diseases of rectum are:

Rectal Prolapse Symptoms

This condition is characterized by protrusion of rectum through the anus. It can a partial prolapse or complete. In partial prolapse, the mucus membrane of rectum protrudes outside the anus for not more than 1 to 3 cm. The condition occurs most often in children between one and three years of age and in old people.

Complete prolapse is less common than partial rectal prolapse. It is characterized by protrusion of almost whole of the rectum. Complete rectal protrusion is common in elderly and women.

In women it is often associated with prolapsed uterus or past history of hysterectomy. Complete prolapse of rectum is 6 times more common in women.

In children partial prolapse often commences after an attack of diarrhea, whooping cough or too much of straining. In adults the condition is usually associated with third degree hemorrhoids, urethral obstruction, and torn perineum in females.

In children most of the time rectal prolapse heals without surgery, while adults require surgical correction.

Causes Of Proctitis Disease

It results when mucus membrane of rectum gets inflamed. Proctitis is caused due to ulcerative colitis, sexually transmitted disease especially in homosexual men. It can also result from certain bacteria that are responsible for diarrhea and dysentery. Excessive use of antibiotics may cause imbalance in intestinal bacterial flora and this may become a cause for proctitis.

Pain in anus and rectum with passage of blood and mucus is prominent symptom of proctitis. In severe cases there is discharge of pus. There is frequent desire to defecate, but the amount of stool passed is at a time is small. Acute proctitis is usually accompanied with malaise and fever. For diagnosis the physician has to look inside of the anus and rectum with an instrument.

Treatment: The disease is self limiting, however antibiotics and anti amoebic medicines are found effective to hasten healing time.

Carcinoma Of Rectum

This is the fourth most common cancer found in women and its frequency in men has surpassed stomach and lung cancer. Bleeding is the earliest and most common symptom. Often bleeding simulates internal hemorrhoids. There is always a sense of incomplete defecation. This is very important symptom when the tumor is in its early stage. The patient tries several times to evacuate feces but instead passes flatus and small amount of mucus. There is alteration of bowel movement. Patient complains of constipation which was not earlier. Pain is the late symptom. Once detected the treatment consist of radiation, surgery and chemotherapy.

Anorectal Abscess Causes And Symptoms

Abscesses around lower rectum and anal canal are known as anorectal abscesses. These are important as this often culminates in fistula-in-ano. The abscess may be in the anus or inside the rectum. It occurs as a result of blockage of anal or rectal glands. The bacterium has opportunity to grow and multiply in collected material. It also results due to thrombosed external pile. People suffering from Crohn’s disease are at risk of suffering from anorectal abscess.


  • Perianal (60%)
  • Ischiorectal (30%)
  • Sub-mucous
  • Pelvi-rectal

Of all the four, perianal abscess is most common.

The symptoms consist of pain in the anal and perianal area. Other symptoms of inflammation such as redness, swelling and tenderness are present. Due to pain and swelling the patient is unable to sit. Fever, body ache are concomitant symptoms.

Treatment: The use of antibiotics is insufficient as it does not reach the content of abscess. Therefore incision and drainage is proved beneficial for anorectal abscess.

Disorders Of The Anus

Fistula-in-ano: Fistula-in-ano is an inflammatory track which has an external opening (secondary opening) in the perianal skin and an internal opening (primary opening) in the anal canal or rectum. This track is lined by unhealthy granulation tissue and fibrous tissue. Fistula-in-ano usually originates from infection in anal gland, ulcerative colitis, Crohn’s disease, tuberculosis and carcinoma of the rectum.

Symptoms Of Hemorrhoids

These are dilated veins within the anal canal in the sub-epithelial region formed by radicles of the superior, middle and inferior rectal veins.

Hemorrhoids are clearly divided into two categories-

  • Internal
  • External

Internal hemorrhoid means it is situated within the anal canal and internal orifice. It is covered with mucous membrane and it is bright red or purple in color. It is usually commences at the anorectal ring and ends at the dentate line.

The external hemorrhoid is situated outside the anal orifice and is covered by skin. The two varieties may co-exist and is called as interno-external hemorrhoids.

Fissure-in-ano: Fissure-in-ano is a very common and painful condition. Fissures occur most commonly in the midline posteriorly, the least protected part of the anal canal. In males, fissures usually occur in the midline posteriorly (90%) and much less commonly anteriorly (10%).

In females fissures on the midline posteriorly are slightly commoner than anteriorly (60:40). The relative frequency of the anterior fissures in the females can be explained due to trauma caused by fetal head on the anterior wall of the anal canal during delivery.

Pilonidal Sinus Symptoms

This is an acquired condition and seen in adult males. This is hardly seen in females. While sitting the buttocks move and hair broken off by friction and collect in the cleft. When toilet paper is used hair entangled in fecal matter will also be swept into the cleft. Such loose hair travel down the inter-gluteal furrow to penetrate the soft and moistened skin at that region or enter the open mouth of a sudoriferous gland. After the initial entry dermatitis and inflammation start around the loose hair and once the sinus is formed, intermittent negative pressure of the area may suck other loose hair in the pit.

This sinus extends into the sub-cutaneous tissue. Tuft of hair is always seen within such sinus embedded in granulation tissue.

Pruritus ani: It is a common problem. It means intractable itching around the anus. It can be due to various ano-rectal diseases e.g. anal fissure, fistula-in-ano, carcinoma of the anal canal and other causes are dermatitis, jaundice, diarrhea, parasitic causes, allergy, moniliasis etc.