About Swollen Anus:
The anus is an opening that is present at the end of the anal canal and through which all the waste product that remains after digestion of food is eliminated out of the body. Before reaching the anus the stool is collected at the rectum which lies between the anus and the colon. The stool moves through the rectum to the anus when there is excessive pressure put on the rectum due to the stool present in it. Due to this pressure, the anal sphincter opens up allowing the stool to pass through the anal canal to the anus and is eliminated out of the body [2].
The anus has variety of ducts, glands, and tissues in it. These are extremely sensitive to pain and irritation. The anus can become swollen due to a variety of conditions majority of which are completely benign; however. Some conditions might require medical attention [2].
Depending on the cause which is causing the swelling there may be other symptoms experienced by the individual like itching, pain, and burning sensation, especially after a bowel movement. At times, there may even be bleeding from the anus during a bowel movement [2].
What Causes Swollen Anus?
Some of the causes of Swollen Anus include:
Anal Fissure: This is perhaps one of the most common causes of Swollen Anus. This condition occurs when there is a tear in the anal lining. This is seen mostly in people who are chronically constipated or have frequent bouts of loose stools. In rare instances, a tumor or an infection may also result in a tear of the anal lining causing Anal Fissure [1].
An individual with Anal Fissure along with a Swollen Anus will have pain with bowel movements. The individual will also see traces of blood while wiping after the bowel movement. Some people notice the presence of a small lump around the fissure [1].
Perianal Abscess: This is yet another cause for Swollen Anus. An individual is said to have perianal abscess when there is collection of fluid in the glands near the anus. Infection is the primary cause of perianal abscess. Aside from the Swollen Anus, the affected individual will also have drainage from the abscess along with pain and fever. He or she may also have problems with voiding [1].
Hemorrhoids: This is perhaps the most common cause of Swollen Anus. This is a condition that develops when the veins in the anus and the terminal portion of the rectum become inflamed and swollen. Hemorrhoids can be both external as well as internal. In external hemorrhoids, the swelling and inflammation is around the skin of the nus while in internal hemorrhoids the swelling is within the lining of the anus or rectum [1].
Hemorrhoids are quite a common occurrence in the elderly population though at times even young people might also get. This is especially when people eat a low fiber diet. This leads to constipation and the individual has to strain excessively during bowel movements. In some cases pregnant females also tend to develop hemorrhoids.
The affected individual will have Swollen Anus along with severe sensation of itching around the anus, rectal bleeding, pain, and a lump around the anus [1].
Anusitis: Swollen Anus can also occur as a result of anusitis. This is a condition in which there is inflammation of the anal canal. This condition is quite often misdiagnosed as hemorrhoids. The primary cause for anusitis is believed to be inflammatory bowel disease; however it can also be caused due to infections and frequent bouts of diarrhea [1].
Eating hot and spicy food on a persistent basis is also believed to be one of the causes for anusitis. Along with Swollen Anus the individual with anusitis will also have bleeding while passing bowels, painful bowel movements, and itching around the anus [1].
Anal Fistula: This is a condition in which there is a tear that develops under the skin and joins the bowel and an abscess. Studies suggest that anal fistula is quite a common occurrence up to the tune of 50% in people with an abscess. The affected individual with an anal fistula will have a Swollen Anus along with pain in the anal region, drainage from the anus, and rectal bleeding [1].
Anal Cancer: This is one of the rare causes of Swollen Anus. According to the American Cancer Society there will be around 8000 new cases of anal cancer by 2019 in the United States. The symptoms of anal cancer are quite similar to other conditions affecting the anus and include Swollen Anus, bleeding and itching sensation in the anus, pain, abnormal discharge from the anus, and abnormal changes in bowel pattern [1].
Anal Sex: This can also causes Swollen Anus. This occurs as a result of friction during sexual intercourse which can irritate the sensitive anal region and cause tear, bleeding and swelling. Thus it is important to have knowledge about how to do anal sex safely before trying it with the partner [1].
How is Swollen Anus Diagnosed?
The diagnosis of a Swollen Anus begins with a thorough history and physical examination of the patient. In some cases, just an inspection of the anal area is good enough for the physician to diagnose the cause for Swollen Anus. In other cases, a digital rectal examination is carried out by the physician [2].
This is especially done if there is suspicion of internal hemorrhoids where the physician will insert a gloved finger into the anal canal. The physician may also order addition tests and investigations to include [2]
Anoscopy:This is done to examine the lower rectum and the anal lining for any abnormality. An Anoscope is used for doing this.
Flexible Sigmoidoscopy: This is done to check for any evidence of hemorrhoids as a cause for Swollen Anus. For this, a flexible sigmoidoscope is used with an attached camera. This instrument is then inserted into the anus and the area of the rectum and lower colon is explored.
Colonoscopy: This test is done mainly for diagnosing colorectal cancer which at times can also cause Swollen Anus. For this, a colonoscope with an attached camera is inserted and the rectum and colon are explored to look for any abnormality.
The results of these tests definitively confirm the accurate cause of Swollen Anus [2].
How is Swollen Anus Treated?
With regard to the treatment of Swollen Anus, it is based depending on what is causing the swelling. Some of the treatment options for the causes mentioned above include
Anal Fissure: For this condition, generally home remedies are good enough for treating it. Doing sitz baths where the individual sits on a half-filled bathtub for about half an hour two to three times a day is quite effective for symptoms relief. This is especially beneficial if it is done immediately after a bowel movement. Eating a diet rich in fiber to prevent constipation and have a smooth bowel movement is yet another way to treat anal fissure [1].
For people who are chronically constipated stool softeners like MiraLax are quite effective in softening the stools so that they can pass smoothly without any pain or irritation in the area. Some people find topical pain relievers quite effective in controlling the pain and reducing swelling of the anus due to anal fissures [1].
In cases where anal fissures become chronic and do not respond to home remedies and medications then surgery is recommended to treat the condition. Some physicians also recommend use of Botox injections into the anal sphincter so treat the symptoms of anal fissure [1].
Perianal Abscess: This condition in majority of the cases requires surgical drainage. This is especially done in people with a compromised immune system and diabetics. It may require around a month for the wounds after drainage of the abscess to heal completely [1].
Hemorrhoids: This condition is quite easy to treat with home remedies. This will include incorporating high fiber in the diet. Using stool softeners like MiraLax are also effective in allowing the stools to pass through smoothly without causing any pain or discomfort while the hemorrhoid heals. Doing sitz baths three to four times every day till the condition heals is also quite effective [1].
It is also recommended for people with hemorrhoids to avoid straining while passing bowels and also not to spend excessive time on the toilet. If the hemorrhoids are internal then it may need medical intervention in the form surgery to treat the condition [1].
Anusitis: The treatment for this condition will depend on the cause of it. If anusitis is caused due to inflammatory bowel disease or infection the medical intervention will be required to treat the condition. Otherwise, anusitis can be effectively treated with home remedies like sitz baths, increased fiber diet, and applying cold packs for 15-20 minutes two to three times a day [1].
Anal Fistula: This in almost all the cases is treated by surgery to close the fistula.
Anal Cancer: This will require a detailed investigation by the physician as to the severity of the cancer and how far it has spread. This will help the physician in formulating a treatment plan best suited for the patient. Additionally, the age and overall health status of the patient will also be taken into account while deciding on the treatment. Based on all the results of the investigations and locating the tumor, a surgery will be performed to remove the malignant growth followed by radiation and chemotherapy [1].
In conclusion, Swollen Anus can be caused due to a variety of medical conditions. Anal fissures, hemorrhoids, anal fistula, and perianal abscess are the most common causes of Swollen Anus. All these conditions are completely treatable with home remedies and diet and lifestyle modifications. Very rarely do these conditions require medical intervention. Constipation is the primary cause for most cases of Swollen Anus and increasing fiber in the diet and using stool softeners is the best way to treat constipation [1, 2].
In rare cases, anal cancer may cause Swollen Anus. Thus it is recommended that if the swelling does not go down and the pain and discomfort worsens despite the treatments mentioned above then a consultation with a physician is a must. This is important to rule out potentially serious causes of Swollen Anus and if such a condition is diagnosed then starting treatment for it immediately [1, 2].
If Swollen Anus is accompanied by rectal bleeding, severe pain, and changes in bowel habits then again a consultation with a physician is recommended to look for a cause of the condition and formulate a treatment plan to prevent any unwarranted complications [1, 2].
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