TREATMENT OF CIRCULAR DISEASES

The perianal diseases treated by the surgical team of Dr. Konstantinidis include:

• Anal fistula: an abnormal channel between the intestine and the skin around the anus, which usually forms after an untreated anal abscess.
• Anal abscess: a cavity around the anus that fills with pus, usually because an anal gland is blocked.
• Anal fissure: an elongated, painful slit in the anal tract.
• Hemorrhoids: normal blood vessels of the anal area that become a problem when they swell and the tissues holding them in place relax.
• Pilonidal cyst: forms under the skin on the natal cleft of the buttocks and turns into an abscess if it becomes infected.

Symptoms differ depending on the condition. An anal fistula mainly causes pain, redness and swelling, usually with pus draining onto the skin, while with an anal abscess the pain is persistent and fever may also occur. An anal fissure causes strong pain during or immediately after a bowel movement, and the pain can last for 2 to 6 hours. Internal hemorrhoids usually do not cause pain but show up as bleeding, while an infected pilonidal cyst causes swelling at the end of the spine that is uncomfortable when sitting.

Any discomfort in the anal area should be assessed immediately by a specialist.

Perianal diseases call for a specialized surgeon with experience in the pathology of the anal area. With hemorrhoids, for example, the surgeon makes the diagnosis and differentiates them from fissures, rectal prolapse and anal abscesses.

As a rule, the diagnosis is made during the clinical examination. When needed, it is supplemented by endoscopy, ultrasound or MRI, and for an anal fistula a colonoscopy may also be performed to check for Crohn’s disease.

Treatment differs for each condition:

• Anal fistula: always surgical, with minimally invasive methods such as FiLaC, LIFT and VAAFT.
• Anal abscess: purely surgical, with timely opening and drainage.
• Anal fissure: when medication and ointments fail, laser or radio frequency (RF) treatment is used, often with a partial internal lateral sphincterotomy. The operation lasts 20-30 minutes and the patient usually returns home on the same day.
• Hemorrhoids: early-stage treatment can be conservative, while persistent hemorrhoids are treated surgically, with methods such as Doppler-guided THD and HAL-RAR or the LHP and HeLP laser techniques.
• Pilonidal cyst: treated with surgical removal or with the endoscopic EPSiT and FiLaC techniques, which are performed under local anesthesia.