Hemorrhoids are enlarged bulging vein(s) of the anus and lower rectum. There are 2 types, internal and external. The vessels grow and bulge secondary to things like pregnancy and constipation. They cause a variety of symptoms, including, burning, bleeding, itching and drainage. Often simple office based treatments and simple lifestyle changes can significantly reduce, if not resolve symptoms. Yes, true, hemorrhoids surgery can be painful, but the majority of the time, this is not required. There are also a variety of other anorectal diseases which can have symptoms similar to hemorrhoids but are treated quite differently; only a good medical history and examination of the area can tell.
Fecal incontinence is uncontrolled leakage of stool from the anus, varying from mild leakage to complete loss of stool. These symptoms are devastating and often cause women to socially withdraw. The surgical options for this used to be quite limited, invasive, and had limited long term effects. Treatment always starts with lifestyle and physical therapy, but when this does not help, new technology like injectable or nerve stimulators have revolutionized treatment for this condition with excellent outcomes. Again, a comprehensive medical history and examination can tell which option may be best for you.
Pelvic floor dysfunction is often confused with constipation. It involves discoordination of the pelvic floor muscles, which don’t relax appropriately, preventing the stool to completely or efficiently evacuate. Patients complain of long standing constipation with the inability to empty despite straining and the urge to have a bowel movement. If they are able to have a bowel movement, they report a feeling of incomplete evacuation, requiring recurrent trips to the bathroom. All the laxatives in the world won’t fix this problem, and often makes it worse. There are simple office based tests to evaluate for this problem and physical therapy (PT) remedies 75-80% of these problems, to get women back to a normal routine.
Rectal prolapse is telescoping of the rectum thru the anus and occurs much more commonly in women: Rectal prolapse is often caused by age, chronic constipation, or child birth. This problem is only treatable by surgery, but the type of surgery is dictated by a combination of age, physical condition, extent of prolapse and functional testing. These type of surgeries can often be performed laparoscopically or robotically to reduce the hospital stay and recovery, and in combination with urogynocology if warranted. Again, only a good patient evaluation can tell what is right for each individual.