Haemorrhoids & Anal Fissure

Anorectal disorders are common conditions that affect the area around the anus and rectum, causing discomfort, pain, and embarrassment.

At Sydney Surgical Associates, we offer expert diagnosis, treatment, and surgery for a range of anorectal disorders.

Whether it’s haemorrhoids, anal fissures, pilonidal sinus, or anal fistulas, our team of experienced surgeons is dedicated to providing effective solutions to improve your quality of life.

Haemorrhoids are swollen blood vessels in the rectum or anus that can cause significant pain, bleeding, and itching. Haemorrhoids are common, particularly in individuals over the age of 50, and are more prevalent in people with a family history, those who are pregnant, or those who experience chronic constipation.

Causes and Risk Factors

  • Chronic constipation or straining during bowel movements
  • Prolonged sitting, particularly on the toilet
  • Pregnancy
  • Obesity
  • Family history of haemorrhoids
  • Age, as tissue becomes weaker with age

 

Symptoms

  • Painful or itchy lumps near the anus
  • Bright red blood on toilet paper or in the toilet bowl
  • Discomfort or pain during bowel movements
  • Swelling around the anus

 

Treatment Options

For mild cases, haemorrhoids can often be managed with lifestyle changes, topical treatments available from the chemist, and medications. However, for more severe or persistent cases, surgery may be necessary. Treatment options include:

  • Rubber band ligation: A non-surgical procedure where a small rubber band is placed around the haemorrhoid to cut off its blood supply, causing it to shrink.
  • Haemorrhoidectomy: Surgical removal of the haemorrhoids. This is typically reserved for large, painful haemorrhoids or those that do not respond to other treatments.
  • Stapled haemorrhoidopexy: A less invasive surgical technique that involves stapling the haemorrhoids back into place to reduce their blood supply.

 

In Australia, approximately 50% of people over the age of 50 will experience haemorrhoids at some point in their lives.

An anal fissure is a small tear or crack in the skin around the anus that can cause severe pain, especially during or after bowel movements. These fissures often occur in individuals with chronic constipation, diarrhoea, or those who experience trauma to the anal area.

Causes and Risk Factors

  • Straining during bowel movements
  • Chronic constipation or diarrhoea
  • Childbirth or trauma during delivery
  • Crohn’s disease or other inflammatory bowel conditions
  • Poor blood flow to the area

 

Symptoms

  • Severe pain during or after bowel movements
  • Bright red blood on the stool or toilet paper
  • Itching or irritation around the anus
  • A visible crack or tear in the skin around the anus

 

Treatment Options

Most anal fissures heal with conservative treatments such as dietary changes, stool softeners, and topical treatments. However, if the fissure persists or becomes chronic, surgery may be required. Surgical options include:

  • Lateral internal sphincterotomy: A surgical procedure that involves cutting a small portion of the anal sphincter muscle to reduce pressure, which helps the fissure heal.
  • Fissurectomy: Removal of the fissure and any surrounding scar tissue.

 

In Australia, anal fissures affect approximately 1-in-5 adults, particularly those aged 20-to-40 years.

A pilonidal sinus is a small hole or tunnel in the skin at the top of the buttocks, often containing hair or skin debris. Pilonidal disease typically occurs in young adults and is more common in men than women. The condition can become painful when an infection occurs, leading to abscess formation.

Causes and Risk Factors

  • Excessive hair growth in the area
  • Sitting for long periods, which increases pressure on the area
  • Family history
  • Poor hygiene or trauma to the skin

 

Symptoms

  • Pain or swelling near the tailbone
  • Redness or warmth around the affected area
  • Pus or blood draining from the hole
  • An unpleasant odour

 

Treatment Options

Most cases of pilonidal disease can be treated with conservative measures such as warm compresses and antibiotics. However, for recurring infections or abscesses, surgery is often necessary. Surgical treatment options include:

  • Incision and drainage: To remove the abscess and drain the infection.
  • Excision and primary closure: Removal of the sinus and surrounding tissue, followed by stitching the wound closed.
  • Flap surgery: In severe cases, a flap of skin may be used to cover the wound and promote healing.

 

Pilonidal sinus is common in people aged 16-to-30 and is estimated to affect approximately 1-in-1000 people.

An anal fistula is an abnormal tunnel or passage that forms between the anal canal and the skin near the anus, often as a result of an abscess or infection. Fistulas can cause chronic pain, swelling, and discharge, and may become a recurring problem if not treated properly.

Causes and Risk Factors

  • Infection or abscess in the anal glands
  • Inflammatory bowel diseases such as Crohn’s disease
  • Trauma to the anal area
  • Previous surgery or radiation therapy in the pelvic region

 

Symptoms

  • Pain or discomfort around the anus
  • Drainage of pus or blood from an opening near the anus
  • Swelling and tenderness
  • Irritation or itching around the affected area

 

Treatment Options

Surgical treatment is usually required for anal fistulas. The goal is to remove the fistula while preserving the function of the anal sphincter muscles. Surgical options include:

  • Fistulotomy: The most common procedure, which involves cutting open the fistula to allow it to heal from the inside out.
  • Seton placement: A thread or material is placed through the fistula to help it drain and allow it to heal over time.
  • Flap surgery: Used for complex fistulas that involve a large portion of the sphincter muscle.

Why Choose Sydney Surgical Associates?

At Sydney Surgical Associates, we offer advanced diagnostic techniques and a range of surgical options to treat anorectal disorders. Our highly skilled surgeons provide personalised care to ensure optimal outcomes and a speedy recovery. We understand the sensitivity of these conditions and are committed to offering compassionate, confidential care throughout your treatment.

Book a Consultation

If you're experiencing symptoms of an anorectal disorder, don't wait to seek treatment. Contact Sydney Surgical Associates to schedule a consultation with one of our experienced surgeons today.