COLORECTAL SURGERY BLOG

Hemorrhoidal disease is a considerable source of morbidity, affecting twenty million adults per year. Symptoms can be debilitating and costly when measured in time away from productive activities. In 1980, during game two of the World Series between the Kansas City Royals and the Philadelphia Phillies, George Brett was forced to leave the game in the sixth inning due to hemorrhoidal symptoms. After a minor surgical procedure, he returned for game three and hit a first inning home run blast in the Royals 4 to 3 win. He quipped “…my problems are all behind me…” The Royals lost the series and Brett underwent a hemorrhoidectomy in the off season.

Hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome accounts for four percent of all colorectal cancers. HNPCC is usually the result of an inherited mutation in one of the group of genes known as mismatch repair genes (MMR). This mutation has also been known to arise spontaneously. MMR genes correct errors that result from faulty DNA replication. Colorectal cancer occurring in the absence of polyps or polyposis is the final phenotypic expression of this DNA mutation, although an occult polyp remains the precursor lesion of the cancer.

Anal itching. Pruritus ani. At one time or another, everyone has experienced this unpleasant sensation. Most often, the delightful scratching of the itch relieves the discomfort and puts a stop to the maddening sensation. Not uncommonly however, the itch occurs at an inconvenient moment, in public, during an intimate social situation or at a time when scratching is not possible without looking a bit ridiculous. Worse, the itching may become chronic, with the need to scratch becoming a constant annoyance, bordering on pain.

Anal fissures are a common problem, bringing many patients to the colorectal surgeons’ office with complaints of anal pain. Most patients report feeling a tear, or a splitting sensation at the anus after a normal bowel movement, a bout of diarrhea, or after a particularly hard or large stool.

Squamous cell carcinoma of the anus is the most well known member of an uncommon group of GI neoplasms. The incidence of this tumor has been increasing slowly, with 3,500 cases reported in the United States in 2001, and 5,260 cases reported in 2009.