Non Surgical Treatments

Many common bowel conditions can be treated effectively without surgery. However, when a condition becomes more advanced or complex, surgery is sometimes necessary.

Surgical procedures for bowel conditions are continually evolving and improving. Wherever possible, your doctor will recommend the least invasive surgical option although this will be determined by the type and severity of the condition, as well as other factors such as your age and general health and wellbeing.

All of these techniques are proven to be effective.

Anal Conditions

Haemorrhoids:

  • Over-the-counter medications (creams or suppositories) are often highly effective at reducing or alleviating haemorrhoids. Many contain hydrocortisone, which is a numbing agent.
  • Lifestyle changes – increasing your intake of fibre and upping your fluid intake can make your poo softer and more bulky, making it easier to pass without straining.
  • Defecatory dynamics – your doctor will discuss your toilet habits with you to ascertain what can be done to help.
  • Banding – One or two bands are placed around the base of the haemorrhoid to cut off its circulation. Over time, it withers and falls off.
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.

Anal Pain:

  • Biofeedback therapy – This is a treatment programme that uses neuromuscular conditioning to treat anal pain, faecal incontinence and constipation. Patients learn muscle exercises to ease their symptoms.
  • Diltiazem ointment.
  • Medications such as amitriptyline.
  • Relaxation techniques – Learning to relax the sphincter muscles can assist in combatting anal 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.

Anal Warts:

Imiquimod is used to treat external genital viral warts.

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.

Anal Fissure:

  • Lifestyle changes – increasing your intake of fibre and upping your fluid intake.
  • GTN ointment.
  • Diltiazem ointment.
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.

Pruritus Ani

  • Hygiene improvements.
  • Steroid cream.
  • Antihistamine.
  • Emollient cream in place of soap.
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.

Abscess:

  • Antibiotics.
  • Drainage with a needle.
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.

IBD

Crohn’s Disease:

There is a range of possible medical therapies that your doctor may suggest, including:

  • 5-ASA.
  • Azathioprine.
  • Mercaptonpurine.
  • Methotrexate.
  • Steroids.
  • Biological therapies (Infliximab, Adalimumab, Golimumab, Vendolizumab).
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.

Ulcerative Colitis:

The range of possible medical therapies is broadly the same as for Crohn’s Disease.

  • 5-ASA.
  • Azathioprine.
  • Mercaptonpurine.
  • Methotrexate.
  • Steroids.
  • Biological therapies (Infliximab, Adalimumab, Golimumab, Vendolizumab).
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.

Pelvic Floor Disorders

Incontinence:

  • Lifestyle changes – a decrease in fibre in your diet can assist in combatting faecal incontinence.
  • Immodium.
  • Biofeedback therapy – see under Anal Pain.
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.

Constipation:

  • Lifestyle changes – an increase of fibre in your diet can help to ease constipation.
  • Laxatives.
  • Linaclotide.
  • Lubiprostone.
  • Prucalopride.
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.

Colon and Rectal Cancer

Non-surgical treatment for suspected colon or rectal cancer is only appropriate if the cancer was very small and removed during colonoscopy, or if your general health is not good enough for surgery to be an option.

In some cases when a patient has been diagnosed with rectal cancer and has undergone chemotherapy and radiotherapy the cancer can disappear. In this situation, we would offer a “watch and wait” approach as not all patients will have been cured by that treatment and surgery may be necessary in future.

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.

Experienced bowel doctors, here to help you

The sooner you seek help, the sooner your chances of returning to health and getting your life back on track.

There really is nothing to feel embarrassed about and everything to be gained by coming to talk to our specialists.

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