Proctology

A digital rectal examination (DRE) is a relatively simple test for both and women involving an internal examination of the rectum and is very useful in determining a diagnosis of rectal and anal tumors, prostate cancer in men and uterine or ovarian cancer in women. It can also assist in diagnosing appendicitis and evaluate hemorrhoids.

Hemorrhoids—also called piles- are swollen veins in your anus and lower rectum. They may result from straining during bowel movements or increased pressure on the veins during pregnancy, obesity, anal intercourse or inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.

Rectal pain occurs mainly with external hemorrhoids since they are located beneath the skin on the outer aspect of the anus. Blood may pool under the skin forming a hard, painful lump. This is called a thrombosed or clotted hemorrhoid. A thrombosed external hemorrhoid may cause significant swelling and pain. You might also notice streaks of blood on the toilet paper after straining to pass a stool.

Internal hemorrhoids are located on the outside lining of the rectum and cannot be felt unless they prolapse (slip down) and push through the anus opening. The most common symptoms of internal hemorrhoids are rectal bleeding, pain and itching. You may find bright red streaks of blood on the toilet paper or bright red blood in the toilet bowl after having a normal bowel movement. Blood also may be visible on the surface of the stool.

An anal fissure is a tear in the lining of the anus or anus canal. This can be caused by any trauma or injury that stretches and tears the anus. Symptoms may include burning and itching around the anus, small amounts of blood on the surface of the stool and toilet paper, pain during and after bowel movements and smelly discharge.

Anal tags are a common and benign skin issue. They are growths or skin tags that hang off the skin around the outside of the anus. Small ones are very common; larger ones associated with swelling, itching or a rash may need additional medical attention.

Dr. Cole believes the initial treatment for all hemorrhoids is medical therapy. Only after failure of conservative treatment should surgery be considered.

Bleeding during bowel movements, itching, and rectal pain are the most common hemorrhoid symptoms. Additional symptoms may include:

• Pain and discomfort during passing stool