FAQs
Rectal Bleeding (Due to Haemorrhoids)

An anal fissure, which is a small tear in the skin of the anus, can cause a burning or gnawing pain that can go on for several hours after you’ve been to the toilet. In some cases, you may experience a severe, sharp pain when you poo or notice a small amount of blood when you wipe your bottom.

Haemorrhoids or piles can cause a lump in or around your anus that can become sore or itchy. If the blood supply to the haemorrhoid becomes blocked, for example by a blood clot, your bottom can become very painful.

A condition called proctalgia fungax can lead to episodes of sudden, severe anal pain. Your doctor can prescribe medication to relax the muscles in the pelvis if this diagnosis is confirmed.

FAQ's
Rectal Bleeding Due to Fissure FAQs

A fissure is a narrow tear from the muscles of the anus up into the anal canal. It can be caused by passing particularly large or hard poos. An anal fistula is a tubelike passage that runs from a hole in the skin near the anus up into the anal canal. It can occur after anal surgery or an abscess.

An anal fissure will normally heal within four to six weeks with home treatment. Pain when you go for a poo should be reduced within a few days. You should try to avoid becoming constipated while the fissure heals by eating plenty of fibre-rich foods and drinking water. Some fissures will not heal despite home treatment and these are referred to as chronic fissures.

It depends on the severity of the fissure. Your GP will normally recommend home treatment first. However, if the fissure persists and becomes chronic you may require surgery to repair it.

FAQ's
Anal Warts

You normally get genital warts (including anal warts) by coming into contact with someone who is infected. Warts can remain dormant in someone’s system for up to six months so they can be passed on to others without the carrier realising. You can also get them by sharing sex toys or towels.

Unfortunately not. Anal warts will remain until you have an effective course of treatment to get rid of them. There are surgical and non-surgical treatments depending on the severity of the problem.

Genital and anal warts can vary in colour from pink to purple, white or grey. They start off small but can grow to up to half an inch in length. They tend to appear in clusters and may resemble a cauliflower.

FAQ's
Anal Pain

An anal fissure, which is a small tear in the skin of the anus, can cause a burning or gnawing pain that can go on for several hours after you’ve been to the toilet. In some cases, you may experience a severe, sharp pain when you poo or notice a small amount of blood when you wipe your bottom.

Haemorrhoids or piles can cause a lump in or around your anus that can become sore or itchy. If the blood supply to the haemorrhoid becomes blocked, for example by a blood clot, your bottom can become very painful.

A condition called proctalgia fungax can lead to episodes of sudden, severe anal pain. Your doctor can prescribe medication to relax the muscles in the pelvis if this diagnosis is confirmed.

FAQ's
Pruritus Ani

The condition can be made worse by heat, moisture around the anus which may be caused by sweating or incomplete drying after washing, poo coming into contact with the skin around the anus, stress and anxiety. Be careful to wipe your bottom thoroughly after going to the toilet and always dry yourself properly after washing. Try to avoid scratching the itch which can make it worse.

It is believed that up to five in every 100 people may suffer from an itchy bottom. The condition is more common in men than women and most often affects people between the ages of 40 and 60. However, anyone can be affected, including children.

Certain foods when they are not fully digested are known to irritate the skin around the anus when you go for a poo. These include: citrus fruit, grapes, tomatoes, spices and chilli, milk, beer and caffeine. There are lot of other potential causes too so it is a good idea to talk to your doctor to try and identify the root cause.

FAQ's
Abscess

A perirectal abscess is a collection of pus in the deep tissues around the rectum. A perianal abscess is shallower, occurring just under the skin surrounding the anus. Both may be referred to as an anal abscess.

An anal abscess requires immediate medical attention. Delaying treatment can cause the condition to deteriorate and may lead to complications.

Some medical conditions can increase the likelihood of developing an anal abscess. These include: diabetes, Crohn’s Disease, HIV or AIDS, cancer; sexually transmitted disease; pregnancy; or any kind of condition that is treated with medications that suppress the body’s immune system, such as steroids.

FAQ's
Fistula

Anal fistulas need to treated because they will not heal by themselves and there is a very small risk of developing cancer in the fistula tract if they are left untreated for long periods

If left untreated, fistulas can become chronic but it is extremely unlikely this would lead to serious complications although further abscess will occur.

A fistula can cause bleeding and discharge when you go for a poo and can be painful.

FAQ's
Pilondial Disease

Pilonidal cysts normally occur either when:

  • a hair follicle becomes irritated or stretched, which may occur during certain types of exercise such as horse riding or cycling
  • a loose hair gets trapped in the crease between the buttocks
  • you are born with them.

Your doctor will carry out a physical examination.

Keep the area dry and clean and try not to sit on hard surfaces for extended periods. If the cyst becomes infected, soak it in warm water several times a day and use antibacterial soap or an alcohol swab to clean the area if your doctor instructs you to do so. You can take over the counter painkillers if necessary.

FAQ's
Incontinence

Incontinence is extremely common although many people feel too embarrassed to talk openly about it. One in three women experience incontinence at some point in their lives. Faecal incontinence is less common, with 2% of the UK population believed to be affected.

In many cases you can retrain your bladder to overcome bladder weakness. Talk to your doctor about this. You may also be able to take medication to help you to manage your condition. On a practical level, try to ensure it is easy to get to the toilet in a hurry and that there are no obstacles in your way. If you are using incontinence pads, choose ones that fit closely to your body to minimise the chance of leaks.

Diarrhoea, constipation and muscle or nerve damage causes bowel incontinence. The muscles of the rectum and intestines stretch and weaken as we age or during childbirth. Passive incontinence means that you might not realise you need to poo until it is too late. Urge incontinence means that the need to poo comes on so suddenly that you might not make it to the toilet in time.

FAQ's
Constipation

Dehydration is a common cause of constipation as the colon draws water out of food that is in the intestines making it firm and harder to pass through digestive tract. The longer food sits in the colon the more water is extracted making the poo harder and more painful. Drinking water and eating more fibrous food helps to relieve constipation.

Foods that have been shown to alleviate constipation are: fruit (kiwi, figs, berries and apples are particularly good); vegetables; live yoghurt; beans and pulses; flaxseed and coconut water.

Women are three times more likely suffer from constipation than men. The reasons for this are not fully understood but factors such as pregnancy and menopause are believed to play a part as the hormones cause the muscles to relax, including bowel muscles.

FAQ's
Prolapse

Complications can include vaginal bleeding and pain, infection, abnormal discharge, hematoma, damage to adjacent organs, recurrent UTI, urinary fistula and abscess. Mesh that becomes chronically infected can increase the risk of cancer. For this reason we avoid using mesh in prolapse repair surgery.

A prolapse tends to cause discomfort rather than acute pain. It can also interfere with the normal function of organs inside your pelvis, for example creating an urge to open your bowel more often.

A prolapse does not generally improve without surgery. In most cases a prolapse will worsen over time. Rarely a prolapse can fail to return back into the rectum and becomes very swollen, which in turn, can lead to decreased blood supply to the prolapse. If this happens, surgery becomes essential and you should attend your nearest accident and emergency department.

FAQ's
Crohn’s Disease

Unfortunately doctors don’t yet fully understand what causes Crohn’s Disease, which means they also don’t know how to prevent it. Advice is available on managing symptoms and reducing flare-ups. For example, you should avoid foods that exacerbate your condition (you may want to keep a food diary to help you identify these), limit your intake of dairy products, drink plenty of water and be careful to avoid eating too much fibre.

Your doctor will want to run a series of tests to confirm a diagnosis. These are likely to include a blood test, testing your poo for traces of blood and other procedures such as:

  • Colonoscopy
  • CT scan
  • MRI scan
  • Capsule endoscopy
  • Balloon-assisted enteroscopy.

There is currently no known cure for Crohn’s Disease. However, there are treatments to help you manage the symptoms and prevent complications. These include anti-inflammatory drugs, immune system suppressors, antibiotics, nutrition therapy and surgery. Your doctor will advise on the best type of treatment for you.

FAQ's
Ulcerative Colitis

Inflammatory Bowel Disease is the umbrella term for two bowel conditions – Crohn’s Disease and ulcerative colitis. Ulcerative colitis causes inflammation and ulceration of the lining of the rectum and colon.

Doctors do not fully understand what causes ulcerative colitis. Research suggests that it is caused by a combination of factors – your genes, an abnormal reaction of the immune system to gut bacteria and the environment.

At present there is no cure for ulcerative colitis other than surgery. Treatment with immunosuppresants can help to reduce the inflammation; however, only surgically removing the colon and rectum can cure ulcerative colitis.

FAQ's
Colon / Rectal Cancer

There are steps that you can take to reduce your risk of developing colon and rectal cancer but you cannot alleviate it completely. You may want to consider: reducing your consumption of red and processed meat, eating more fruit and vegetables, reducing your alcohol intake, taking regular exercise and losing weight if you are obese.

No. Blood in your poo can be caused by other conditions such as haemorrhoids and diverticular disease but it is important to get it checked out as blood in your poo can be an indicator of bowel cancer

It is important to catch bowel cancer as early as possible to stand the best chance of successful treatment. Bowel cancer affects around 41,000 people in the UK every year. It can be successfully treated if identified before it has had a chance to spread. If polyps are found in the bowel early enough they can be removed even before they become cancerous.

The majority of colon and rectal cancers occur in people with no family history of the disease. However if you have a close family member who developed the condition before the age of 60, you will be at increased risk and may be offered additional screening.

FAQ's
Endoscopy

No, you are likely to experience mild discomfort during an endoscopy but it will not be painful. You may be given a sedative to help you to relax and you may be given a local anaesthetic.

Rarely you can develop an infection in the part of the body that is being examined. This will be treated with antibiotics if it occurs. Another rare complication is perforation of an organ or excessive bleeding which may require surgery or a blood transfusion. Sometimes the medication used to sedate you may cause sickness, irregular heartbeat or breathing difficulties.

Yes, you will be able to go home once the effects of the sedative have worn off, although a friend or relative will need to take you home.

FAQ's
Colonoscopy

A colonoscopy is a commonly used procedure and complications are rare. However, as with any medical procedure there are some small risks. Rarely you might experience bleeding, a tear in the bowel or infection. If these do occur they will be treated with antibiotics or surgery.

A colonoscopy is a highly effective way of detecting polyps in the colon or rectum, as well as other abnormalities. If left untreated, polyps can go on to develop into colorectal cancer so it is important to identify and treat them as early as possible.

You will be given detailed instructions by your doctor and it is important to follow these. Certain foods mimic the appearance of blood or abnormalities in the colon and should be avoided. It is important that the colon is empty to provide the best visibility during the colonoscopy. You should avoid eating the day before the procedure, as instructed on your appointment letter.

FAQ's
Gastroscopy

You may experience a gagging sensation when the endoscope is inserted into your throat - this is reduced by spraying anaesthetic into your throat. You may develop a mild sore throat afterwards.

A gastroscopy is quick. The procedure takes approximately 15 minutes and you will need around half an hour to recover from the effects of sedation, if you received it. You will need someone to accompany you home if you were sedated.

Complications are rare with this procedure however they can occur. You may have a sore throat afterwards. Rarely there is a risk of more serious complications including bleeding, perforation, inhaling liquid into the lungs and an allergic reaction to any drugs administered.

FAQ's
CT Scan

No. The scan is very quick and the scanner does not surround your body unlike an MRI scan so you won’t feel any anxieties associated with being in a confined space.

A CT scan exposes you to radiation. The levels are low however any exposure to radiation increases your risk of developing cancer.

CT scans can be used to detect cancer, to find out where the cancer is, whether it has spread and if it is interfering with your normal body function.

FAQ's
CT (Virtual) colonoscopy

A virtual colonoscopy uses a CT scan that produce X-ray images of the inside of your bowel. With a conventional colonoscopy a narrow flexible tube containing a camera is inserted into your anus and gently fed into your bowel.

With a virtual colonoscopy a tube is inserted just a short way into your anus to allow air to be pumped into your bowel. A conventional colonoscopy enables your doctor to take biopsies or remove polyps, whereas this is not possible with a virtual colonoscopy. Virtual colonoscopies may be safer if you are elderly and frail or your bowel is blocked.

A virtual colonoscopy can be used to identify ulcers or polyps or to show swollen or irritated tissue. It is used to diagnose conditions such as bowel cancer.

You will be able to go back to your normal activities immediately after having a virtual colonoscopy. You may feel a bit bloated and have trapped wind due to the air that was pumped into your bowel but these symptoms should quickly pass.

FAQ's

MRI

MRI scans are safe and painless however some people find them claustrophobic as you lie on a flat bed that moves inside the scanner. Your radiographer will talk to you during the procedure and you may be offered sedatives if you are anxious. There is no evidence to suggest that MRI scans pose a risk to health and they are considered one of the safest medical procedures.

An MRI scan does not use x-rays, which means they are safe for people who could not normally have an x-ray such as pregnant women and babies. They work using magnetic fields and radio waves.

No, although MRI scans are very safe, the strong magnets used during the scan can affect any metal implants or fragments in your body. MRI scans may not be performed if you have any metal in your body or if you are in the first three months of pregnancy, as an added safety precaution. Talk to your doctor if you suspect you may have metal in your body, such as metal plates, screws or rods, or a pacemaker or drug pump implant.

FAQ's
Haemorrhoids Treatment

The condition can be made worse by heat, moisture around the anus which may be caused by sweating or incomplete drying after washing, poo coming into contact with the skin around the anus, stress and anxiety. Be careful to wipe your bottom thoroughly after going to the toilet and always dry yourself properly after washing. Try to avoid scratching the itch which can make it worse.

It is believed that up to five in every 100 people may suffer from an itchy bottom. The condition is more common in men than women and most often affects people between the ages of 40 and 60. However, anyone can be affected, including children.

Certain foods when they are not fully digested are known to irritate the skin around the anus when you go for a poo. These include: citrus fruit, grapes, tomatoes, spices and chilli, milk, beer and caffeine. There are lot of other potential causes too so it is a good idea to talk to your doctor to try and identify the root cause.

FAQ's
Anal Fissure Treatment

Gently clean and dry your bottom after going for a poo but be careful to avoid scented soap or bath oil. Soaking your bottom in the bath can help to reduce pain and promote healing.

Take measures to reduce constipation and prevent poos from becoming large and hard. Increase your fibre intake (fresh fruit and vegetables, brown rice and bread), drink plenty of water, go for a poo when you need to go and talk to your doctor about other preventative measures.

Coconut oil is an excellent moisturiser and gentle enough to use on the anus. As well as tackling dryness and soreness it also appears to help to heal the wound.

FAQ's
Anal Warts Treatment

The cream appears to boost your immune system to help your body fight the virus that causes warts. While using the cream you should avoid sexual contact as it can weaken condoms and diaphragms and may irritate your partner’s skin.

Trichloroacetic Acid (TCA) is a chemical treatment that is used to burn off genital warts, including internal warts. It can cause some skin irritation and pain but is an effective treatment.

No, these treatments are not suitable for the delicate anal or genital area and may cause irritation and pain.

FAQ's
Anal Pain Treatment

Anal pain can be caused by a number of factors including haemorrhoids, anal fissures, anal spasms, and other less common causes including cancer, prostate problems and foreign bodies.

You should not need to seek urgent medical attention for anal pain unless: you start to bleed from your bottom, or the pain is becoming severe, or you have something stuck up your bottom.

When you have an anal spasm attack, it is normally short-lived although it can be intensely painful. Your doctor may suggest muscle relaxers, asthma medication, ointments to improve blood flow to the anus or Botox.

FAQ's
Pruritus Ani Treatment

Your doctor may prescribe a cream or ointment containing steroids, which may help to relieve the itching and irritation. If the itching is caused by an infection you may also need oral medication, such as an antibiotic.

Certain foods and drinks can contribute to the problem including: chocolate, tea, cola, energy drinks, spicy foods, dairy products, beer, nuts and tomatoes. It is best to avoid these foods if you are experiencing an itchy bottom.

There are so many different causes for the condition that no single treatment will be effective in all cases. It is important to get an accurate diagnosis to find out what is causing the problem before deciding on the most effective course of treatment.

FAQ's
Abscess Treatment

You may be given antibiotics to treat an abscess but these might not be enough to clear the infection completely and the abscess might need to be drained. If an abscess isn’t drained it can continue to fill with pus and could eventually burst which is painful and can cause the infection to spread.

It appears as a painful boil-like swelling near the anus. It may feel warm to the touch, red, shiny and swollen. Abscesses in the deeper anal tissues are less visible and also less common.

Around 40 percent of people who have an anal abscess go on to develop a fistula. This is a small tunnel from the site of the abscess to the skin. It can result in recurrent anal abscesses and will almost always require surgery.

FAQ's
Crohn’s Disease Treatment

There is currently no known cure for Crohn’s Disease. However, there are treatments to help you manage the symptoms and prevent complications. These include anti-inflammatory drugs, immune system suppressors, antibiotics, nutrition therapy and surgery. Your doctor will advise on the best type of treatment for you.

Some foods can trigger the symptoms of Crohn’s Disease. You should try and avoid: alcohol, butter and spreads, carbonated drinks, high fibre foods, coffee tea and chocolate, dairy products. It is a good idea to keep a food diary so that you can identify the foods that are triggers for you.

Yes. Inflammation in the digestive tract can result in serious complications such as infections, fistulas, bleeding and perforation of the intestinal wall. When the condition flares up you may need to spend time in hospital, leading to disruption in your everyday life.

FAQ's
Ulcerative Colitis Treatment

The exact causes are unknown but genetics and environmental factors are believed to play a part. It is an autoimmune condition which means the body’s immune system starts to attack healthy tissue, in this case the lining of the colon.

Ulcerative colitis is normally treated with anti-inflammatory drugs. The precise drugs will be determined by the severity of your condition. You may also be given immune system suppressors which reduce inflammation by suppressing the immune system. Other drugs to control the condition may be given, including antibiotics, iron supplements and painkillers.

Ulcerative colitis leads to an increased risk of colon cancer. As a result you will normally be offered regular colonoscopies to screen for the disease.

FAQ's
Incontinence Treatment

A range of treatments can help to treat incontinence, including biofeedback therapy, which is used to treat urge and passive incontinence. The treatment works by slowly increasing how long you can wait before having to open your bowel.

This is a technique for learning to control a bodily function that is not normally under your conscious control.

There are a number of diagnostic tests. Your doctor is likely to perform a rectal examination to evaluate the strength of your sphincter muscle and check for abnormalities.

Other tests include the anorectal manometry and endoanal ultrasound. These tests involve first inserting a small pressure recording device into the rectum, which is then removed and an ultrasound probe is then inserted into the rectum. These tests take approximately 5 minutes and give detailed information about any abnormalities of the sphincter muscle.

FAQ's
Constipation Treatment

Doctors normally advise eating more of some foods and less of others. Fibre-rich foods such as fruit and vegetables, brown rice or pasta, wholemeal bread, beans and pulses can all help, along with drinking plenty of water. Try to avoid too many dairy products, red meat, chips, fatty foods, ready meals and bananas.

There are a number of factors that can contribute to constipation. Most common is not eating enough fibre or drinking enough water. However, you can also be affected by a change in routine or lifestyle, anxiety and depression, ignoring the urge to poo and taking certain medication.

You may be able to treat constipation yourself by making some simple changes, such as improving your diet and drinking more water. However, if this doesn’t help and the problem becomes chronic you should speak to your doctor.

FAQ's
Anal Fissure Treatment

Gently clean and dry your bottom after going for a poo but be careful to avoid scented soap or bath oil. Soaking your bottom in the bath can help to reduce pain and promote healing.

Take measures to reduce constipation and prevent poos from becoming large and hard. Increase your fibre intake (fresh fruit and vegetables, brown rice and bread), drink plenty of water, go for a poo when you need to go and talk to your doctor about other preventative measures.

Coconut oil is an excellent moisturiser and gentle enough to use on the anus. As well as tackling dryness and soreness it also appears to help to heal the wound.

FAQ's
Pilondial Disease Treatment

Pilonidal cysts normally occur either when:

  • a hair follicle becomes irritated or stretched, which may occur during certain types of exercise such as horse riding or cycling
  • a loose hair gets trapped in the crease between the buttocks

Your doctor will carry out a physical examination.

Keep the area dry and clean. If the cyst becomes infected, soak it in warm water several times a day and use antibacterial soap or an alcohol swab to clean the area if your doctor instructs you to do so. You can take over the counter painkillers if necessary.

FAQ's
Prolapse Treatment

Complications can include vaginal pain, infection, abscesses, abnormal discharge, damage to adjacent organs, or urinary fistula. For this reason we avoid using MESH in prolapse repair surgery.

A prolapse tends to cause discomfort rather than acute pain. Very rarely a prolapse will become extremely painful and it will not be possible to push it back into the pelvis because the blood supply is blocked, if this occurs you must go to accident and emergency immediately.

A prolapse does not generally improve without surgery. In most cases a prolapse will worsen over time and surgery becomes essential.

FAQ's
Colon / Rectal Cancer Treatment

There are steps that you can take to reduce your risk of developing colon and rectal cancer but you cannot alleviate it completely. You may want to consider: reducing your consumption of red and processed meat, eating more fruit and vegetables, reducing your alcohol intake, taking regular exercise and losing weight if you are obese.

No. Blood in your stool can be caused by other conditions such as haemorrhoids and anal fissures but it is important to get it checked out as blood in your stool can be an indicator of bowel cancer.

It is important to catch bowel cancer as early as possible to stand the best chance of successful treatment. Bowel cancer affects around 41,000 people every year. It can be successfully treated if identified before it has had a chance to spread. If polyps are found in the bowel early enough they can be removed even before they become cancerous.

The majority of colon and rectal cancers occur in people with no family history of the disease. However if you have a close family member who developed the condition before the age of 60, you will be at increased risk and may be offered additional screening.

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