Anal swellings are often a cause of discomfort and cause significant distress to many patients due to the presence of a swollen enlargement around the anus. Around 15% of individuals with anal swelling report severe pain, which may indicate a more serious condition requiring prompt medical evaluation. This article discusses the causes, symptoms, treatment options, and the crucial instances when seeking medical advice becomes imperative.
Causes of Anal Swelling
The inflammation or injury of the anal or rectal tissue causes proliferative anal disease. Common causes include:
- Haemorrhoids (Piles): India has around 40 million haemorrhoid patients. It is caused by congestion of veins in the lower rectum or anus. Haemorrhoids can develop under the skin around the anus or inside the rectal wall.
- Anal Fissures: Mucosal excoriation lining the anus presents with pain, swelling, and erythema because of tearing from constipation or passage of hard stool.
- Infections: Infections of bacteria or viruses such as Sexually transmitted diseases (STIS), herpes, or Gonorrhea may cause swelling of the anus. About 5% of anal swelling cases are due to allergic reactions, which may necessitate medical advice for proper treatment.
- Abscesses and Fistulas: Anal abscesses are pus accumulations derived from infected glands, which are tender and may present with signs of inflammation.
- Inflammatory Bowel Disease (IBD): Chronic inflammations such as Crohn’s disease and ulcerative colitis can also lead to swelling in the anal region.
- Anal Tumours: Some of the causes are pilling up of moles or growths that, although benign or malignant, cause swelling of the anal area.
- Trauma: Injury to the area often comes from surgery or anal intercourse and from intense straining during defecation, which results in a temporary inflammation of the area.
- Warts (Anal Warts): Anal warts are caused by the human papillomavirus (HPV) and can lead to visible swelling around the anus. These warts typically appear as small, fleshy lumps or bumps and can be itchy or cause discomfort, especially if they grow or form clusters.
- Sentinel Tags (Skin Tags Around the Anus): Sentinel tags are small skin growths or tags that form around the anus, typically because of internal conditions like anal fissures.
- Hidradenitis Suppurativa (HS): Hidradenitis Suppurativa is a chronic skin condition that forms painful abscesses and sinus tracts (tunnels under the skin). It commonly affects areas like the armpits, groin, and around the anus.
- Internal Haemorrhoids – Stage 4: Internal haemorrhoids are swollen blood vessels inside the rectum, and when they reach Stage 4 (the most severe), they prolapse (protrude) outside the anus and cannot be manually pushed back in.
- Rectal Prolapse: Rectal prolapse occurs when the rectum (lower part of the large intestine) slips out of its normal position and protrudes through the anus.
- Rectal Mucosal Prolapse: Rectal mucosal prolapse is a condition in which only the inner lining (mucosa) of the rectum protrudes through the anus without involving the entire thickness of the rectal wall.
Common Symptoms Associated with Anal Swelling
Knowledge of the common symptoms associated with anal swelling will assist with their identification. Common anal infection symptoms include:
- Pain or Discomfort: The pain usually associated with it can be mild to severe and increases when sitting or travelling for some patients.
- Bleeding: Bright red blood may appear on toilet paper, in the stool, or in the toilet bowl, particularly in cases of haemorrhoids or anal fissures. Sometimes, blood clots or dark-coloured blood may also indicate tumours or growths in the rectum or anal canal.
- Itching and Irritation: Persistent itching, medically referred to as pruritus ani, often accompanies swelling.
- Lumps or Hardness: External haemorrhoids or thrombosed haemorrhoids or abscesses may manifest as hard, tender lumps near the anus.
- Discharge or Odour: Anal abscesses and infections may cause pus discharge and an unpleasant smell.
- Systemic Symptoms: In cases of severe infection, fever, fatigue, or malaise may occur, indicating the need for immediate medical attention.
Anal Swelling: Professional Guidance is Essential
Treatment depends on the underlying cause and severity of the condition. Only a doctor can diagnose the reason for anal swelling and suggest the right type of treatment.
For Home Care
After consultation with a qualified doctor, if the condition is not severe, then those cases can be managed with at-home care.
- Hydration and Home Remedies: Drinking sufficient water intake softens stool, making bowel movements less painful.
- Dietary Adjustments: Increasing fibre intake through fruits, vegetables, and whole grains can prevent constipation, reducing strain during bowel movements. Studies show that diets rich in fibre can significantly reduce haemorrhoid symptoms.
- Warm Sitz Baths: Soaking the affected area in warm water for 10-15 minutes daily alleviates swelling and discomfort.
For Medical Treatments
Sometimes, your doctor may recommend medical treatments such as tablets or topical creams to use along with home care for relief from anal swelling. Antibiotics may be prescribed for bacterial infections or abscesses to manage and eliminate infection.
Surgical Treatments
When the conservative treatments don’t resolve anal swelling, and the patient continues to experience painful symptoms, or the condition becomes chronic, surgical treatment is necessary to treat the underlying cause. The recommended surgeries can be:
- Advanced Minimally Invasive Surgeries: Techniques like DG-HAL or laser surgeries offer effective and less invasive solutions for complex cases.
- Infrared Coagulation: It is a minimally invasive procedure for treating conditions like haemorrhoids. Heat is applied to haemorrhoidal tissue in this procedure to reduce its size.
- Haemorrhoidectomy: Large or recurrent haemorrhoids may be surgically removed.
- Fistulotomy or Drainage: Surgical drainage is necessary for abscesses, and fistulas may require advanced surgical repair.
- Fissures: Managed with sphincter tone optimisation, medications, and lifestyle modifications.
When to See a Doctor for Anal Swelling
While most instances of anal swelling resolve with home care, specific symptoms necessitate medical attention:
- Persistent Symptoms: If swelling, pain, or bleeding persists for over a week, a doctor’s evaluation is necessary.
- Severe Pain or Swelling: Intense, unbearable pain or sudden, large swellings (thrombosed haemorrhoids) require urgent care.
- Signs of Infection: Anal abscesses, which are infections in the anal area, affect about 1 in 10,000 people annually. Fever, chills, or pus discharge indicate a potential abscess or infection that must be treated promptly.
- Unexplained Bleeding: Rectal bleeding should always be evaluated to rule out severe conditions like colorectal cancer. Studies confirm that even minor bleeding warrants thorough investigation.
- Recurrent Issues: Chronic or recurring anal swelling may indicate underlying conditions like IBD or structural issues.
Preventing Anal Swelling
Prevention focuses on maintaining healthy bowel habits:
- Avoid prolonged sitting on the toilet.
- Exercise regularly to promote digestion.
- Address constipation early with dietary changes or mild laxatives.
- Maintain good hygiene around the anal area.
What We Advise at Chirag
At Chirag Hospital, we take a tailored approach to treatment, ensuring that each patient receives the most appropriate care based on their specific symptoms and condition. Unlike generalized advice, we follow evidence-based practices and provide interventions that align with our medical philosophy.
- For conditions like haemorrhoids, fissures, or fistulas, we prioritise minimally invasive techniques, including DG-HAL and laser surgeries, for effective results.
- Our advanced diagnostic tools and expertise in conditions like IBD and infections ensure precise treatment plans.
- Prevention-focused guidance, including dietary and lifestyle adjustments, is central to our care philosophy.
Other options are available, such as rubber band ligation, sclerotherapy, and fibrin glue, for conditions like haemorrhoids and fistulas, but we prefer minimally invasive procedures that offer more effective, long-term results and superior outcomes compared to traditional methods.
Conclusion
Anal swelling is common and often caused by harmless conditions like haemorrhoids or minor infections. Symptoms such as pain, itching, and bleeding can be managed with simple lifestyle changes, good hygiene, and medical management. Timely consultation and treatment are key to resolving anal swelling and preventing further complications. If you have any concerns about anal swelling or related symptoms, we encourage you to schedule a consultation at Chirag Hospital, where we offer personalised, effective care based on your unique needs.
