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Proctology is an area of Gastroenterology dedicated to the diagnosis and treatment of benign and malignant diseases of the anal canal and of the perianal region.
There are various Proctologic (Anorectal) benign diseases, the most common being Haemorrhoidal Disease and Anal Fissures. These deserve a special mention due to their important prevalence among young people. There are other diseases such as Anal Fissure, Perianal Fistula, Anal Fibroids and Rectal Prolepses (rectal invagination towards the anal canal). Faecal Incontinence, Perianal Condyloma (associated with HPV infection).
These occur when there is congestion of the upper haemorrhoidal piles. Defecation effort, an increase in intra-abdominal pressure, the absence of valves in the vessels of the haemorrhoidal piles, chronic constipation, the vertical position of the human being and genetic factors might all be involved in the development of haemorrhoidal disease. The most common symptom of this disease is (red) blood loss during or after defecation.
These are small oval ulcers, normally situated in the lower part of the anal canal. The main symptom is extreme and intense, penetrating pain when defecating, which may continue for several hours. Fear of a new painful defecation leads to chronic constipation. This then results in a “vicious circle”: Pain ► Fear of defecation ► poor blood supply ► Poor healing ► persistent fissure.
These are sometimes complex situations and typically arise after an anal abscess. A fistula connects the canal to the skin. Fistulas are confirmed due to their purulent appearance as open wounds.
Abnormal fibrous tissue, which often indicates chronic proctologic diseases. These lesions are benign but often symptomatic (Pain/anal discomfort, inflammation, hygiene difficulty). Minimally invasive surgery may be necessary, which can be carried out in the Out-Patient Proctology Consultation.
Growths/legions around and/or inside the anus, associated with HPV Infection that should be eliminated in order to prevent malignant progression of the lesions. The type of treatment depends on the location and size of the lesions.
After a diagnosis is reached the patient is referred to the most appropriate treatment. The most common procedures depending on the diagnosis might be:
The appropriate treatment depends largely on the extent of the disease. For internal Haemorrhoids Grade I to IV, the treatment may be performed in the consulting room through Haemorrhoid Sclerosis and/or Elastic Haemorrhoidal Ligation. The most advanced cases (Grade IV) surgery might be necessary - Haemorrhoidectomy.
For acute Fissures, conservative medical treatment is indicated, which is changing eating habits, consisting of a diet rich in fibre and drinking more water, as well as increasing the fluid intake and applying healing ointments. If conservative treatment does not solve the problem Chronic Fissures might need treatment with Botolinum Toxin Injection, Fissurectomy and Fistulotomy.
The treatment implies the introduction of a drain in the path of the Fistula and in some cases a Progressive Fistulotomy is necessary.
We have varied and differential technology for the support of diagnosis and treatment in Proctology, as well as other examinations and specialties for the follow-up treatment.