An anorectal abscess is a painful swelling near the anus or in the buttock. The swelling contains pus. 60% anorectal abscesses are superficial and resulting from infection in small anal glands present in between internal and external anal sphincters (intersphincteric space). They are known as a perianal abscess. 30% of anorectal abscesses are deep-seated and results in systemic infection. They are call Ischiorectal abscess. Submucous abscess, pelvirectal abscess and pilonidal abscess developed from versatile cause are comparatively less common. Inadequate and improper management of anorectal abscess may potentially cause complication like fistula formation.


Fast facts on Anorectal abscess-

* Anorectal abscess should be drained at the earliest.
* Conservative medical management almost invariably invites complication like fistula formation.
* Surgical drainage of pus reduces the chance of fistula formation by 50%.


What causes Anorectal abscess?

* Blocked and infected anal glands (cryptoglandular infection).
* Untreated anal fissure that becomes infected.
* Sexually transmitted infections.
* Penetrating injury of the perianal or buttock region.
* Crohn s disease.
* Colon cancer.
* Tuberculosis.



What are the symptoms of Anorectal abscess?

Superficial abscess-

* Constant and throbbing pain that worsens on sitting down.
* Swelling, redness and tenderness of the skin around the anus.
* Discharge of pus.
* Pain is often associated with bowel movement.

Deep abscess-

* All or some of the symptoms of a superficial abscess.
* Fever with chill and rigor.
* General weakness.
* Sometimes fever is the only symptom of the deep abscess.

The anorectal abscess should preferably be explored under general or spinal anesthesia. Medical management often fails and subsequently fistula is formed.

Anorectal Abscess - Know In Detail About It!

Severe to moderate pain in the rectum during and after bowel movements is an
indication of anal fissure. If it is accompanied by bright red stool and an itching
sensation around the anus, it is more likely to be fissure than anything else. Fissure
is usually treated with sits bath and enhanced intake of fibrous food. If that does not
heal the problem, the doctor may go for a surgery. However, surgical intervention of
fissures is not always a permanent solution. For permanent solution, patients are
now turning to homeopathy. Yes, homeopathy can address the problem at its root
and gift you a permanent cure.
What Need to Know About Fissure?
  The problem mostly precipitates due to inflammation and dryness of the
mucosal end of the anorectal area.
  Straining during bowel movements and passing hard stools strain the anal
mucosa. That is likely to result in fissure.
  People suffering from chronic diarrhoea are also likely to suffer from this
problem.
  People suffering from some kind of inflammation of the anal area due to
diseases like Crohn&#39;s disease or some kind of inflammatory bowel disease
may also suffer from fissure.
  The patient may feel a lump in the area surrounding the anus.
  He or she may also experience spasms at the end of the rectum.
  Even infants may suffer from this problem.
  Many women suffer from fissure after childbirth.

Homeopathic Treatment of Fissure
  Homeopathy is known to address diseases to their roots.
  In case of fissure, homeopathic medicine can address the problem by
preventing and treating dryness and inflammation of the palpable mucosal
area around the anus. If this area is moist, it can stretch better in response to
straining during bowel movements and thereby prevent tearing.
  Since constipation is one of the main causes of fissure, homeopathic doctors
may prescribe medicines for preventing constipation too.
  However, homeopathic medicine is not a one-size-fits-all remedy. The
medicine depends on the constitution of body. The doctor may try to judge
body constitution of the patient by asking him questions about sleep pattern,
food habit, emotional state, working schedule, etc. The doctor needs to take
all these into consideration to prescribe the most appropriate medicine.

  A homoeopathic doctor first gets a conventional diagnosis. If fissure is
confirmed in the diagnosis, the doctor may launch an all out attack on the
problem so that the problem can be nipped in the bud.
Conclusion
Anal fissure is a painful condition that is mostly precipitated by straining during bowel
movements and passing hard stools. Homeopathy can offer permanent solution to
this problem by preventing constipation on one hand and preventing as well as
treating inflammation and dryness of the anal mucosa on the other hand.

Fissure - An Overview!

Colorectal surgery: How to be sure you need it?

Colorectal surgery is performed to repair damages that occur in the organs of the anus, rectum, and colon. The damage that takes place in these organs can be the result of problems with lower GI like diverticulitis (a condition wherein pouches known as diverticula in the colon wall become inflamed), cancer and inflammatory bowel disease (a group of intestinal disorders that bring about inflammation of the GI).

Who needs this surgery?

In general, colorectal surgery is an essential treatment option for ulcerative colitis, colorectal cancer, Crohn's disease (an inflammatory bowel disease that gives rise to inflammation of the gastrointestinal tract) as well as certain diverticulitis cases. In such cases, the intestinal tract undergoes major reconstruction.

There are also other bowel problems that may require surgery but not of a serious nature and these are anal fissures, hemorrhoids, bowel incontinence and rectal prolapse. Most of the surgical procedures will aid in repairing tears, get rid of blockages, or make tighter sphincter muscles (muscles that surround openings in the body).

Colorectal surgery is also performed in cases of pelvic floor disorders like rectocele (a condition in which the rectum bulges towards the vagina) and perineal hernia (a hernia that involves the pelvic floor).

At the same time, injury, ischemia or compromised blood supply and obstruction may require the performance of bowel surgery as well. Scar tissue and masses can form within the rectum, clogging the organ and preventing the normal discharge of feces from the body.

Problems like ulcerative colitis (an inflammatory bowel disease that leads to the development of ulcers in the colon as well as inflammation of the area) and diverticulitis can give rise to perforations in the rectum. Surgery is suggested in instances when drugs fail to treat the problem of ulcerative colitis.

Likewise, in the case of recurrent instances of perforations or complications in diverticulitis, surgery may be required to remove the portion of the colon affected.



Colorectal Surgery: How To Be Sure You Really Need it

Colorectal surgery deals with the disorders of the rectum, anus and colon. Another name of colon is  large intestine . These three body parts form the last stages of the digestive process. When the human waste passes through the colon, its salt and water are extracted before it exits the body as human excreta.

Colorectal disorders

Swelling and inflammation of the veins in the anus (also called as Haemorrhoids)
Anal fissures- unnatural cracks and fissures in the anal area
Fistulas or the unnatural connections between the anus and other anorectal areas
Conditions of constipation
Incontinence in passing of faeces
When the walls of the rectum protrude through the anus- also called as Rectal prolapse
Birth defects such as imperforate anus
Anal cancer- this condition is rare
Colorectal cancer- cancer of colon and rectum
Any injuries to the anus
Removal of any objects inserted into the anus
Bowel habits after colorectal surgery
Many patients report cases of diarrhoea, leakage of stool or gas, urgency to use the toilet and a feeling of insufficient evacuation of faeces. Relax; these conditions are not going to last forever. Your rectum and anus are adjusting to new conditions after this surgery. These organs may take six to twelve months to adjust to new bowel habits.

Is there a need to take a laxative or stool softener?
There is no need to take laxatives after a colorectal surgery. Drink lots of water to make your stool softer and easy to pass. If there is a water deficiency in your body, then it may lead to your faeces becoming hard. In that case, take milk of magnesium, colace etc.

Activities post surgery
You can continue with your normal schedule after this surgical procedure. Carry on running, jogging, exercising, climbing up the stairs etc. even after your surgery. Gastroenterologists recommend that patients should desist from lifting loads weighing more than 10 pounds so that there are no post surgery complications.

Diet after colorectal surgery
Avoid spicy and heavy to digest meals after your surgery. Once the intestines begin working normally, you can continue having your spicy food. Chew your food well to aid its digestion.

Returning to work after colorectal surgery
Most people are back to their work after taking a break of 2-5 days. If the surgery is pretty detailed, you may have to take a break of up to a month. Patients undergoing laparoscopic surgery may have to take a rest of 2- 4 weeks before they report back to work. Take it easy before slipping into your regular schedule. If working hurts after your surgery, don t do it.

Colorectal Surgery - Disorders It Can Treat!

If you notice blood in the stool or the toilet bowl, it could be a case of rectal bleeding. There are many reasons why rectal bleeding can occur, the most common one being haemorrhoids. If the rectal bleeding is not significant then it is not a cause for concern. But if you lose a lot of blood then it can be a major problem.

What are the signs?

The most obvious one, in this case, is the presence of blood in your stool. But it's not just the presence of blood that is important here, the colour of the blood is also a very important indicator of what is wrong.

Black colour indicates that you are bleeding from the upper region of the small intestine

A bright red colour is an indication of the blood loss from the lower part of the gastrointestinal tract   rectum or colon

Dark red indicates that the bleeding is taking place at the initial region of the colon

Some other symptoms you may experience are  

Confusion

Pain in the rectum

Stomach cramps

A sensation of dizziness

Causes of rectal bleeding

Causes of rectal bleeding can be divided into mild and serious. 

Mild causes  

Constipation 

Small tears in the anal lining (anal fissures)

Haemorrhoids

Small growths of tissue in the rectum or colon

Serious causes  

Cancer of the colon and anus

Inflammatory bowel disease

An infection of the intestine such as salmonella

How is it treated?

If you lose a lot of blood, then it is a medical emergency. You should rush to the doctor if you experience the following   fainting, intense pain in the stomach, confusion, and rapid breathing.

The doctor will prescribe treatment based on the cause of your rectal bleeding. For example, if the cause is haemorrhoids then warm baths will help soothe the pain. If the haemorrhoids are large then invasive methods such as laser treatments and surgery are prescribed. 

Or if it is constipation then stool softeners are a good option. In addition, you may have to eat a high fibre diet and exercise regularly to normalize your bowel movements. 

Rectal bleeding can be a minor inconvenience or a major problem depending on the cause. So it is best to consult a doctor and seek immediate treatment.

Rectum Bleeding - How To Administer It?

Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

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