Introduction
Many patients become concerned that they do not have a neat flat anus. It is very common to develop little benign growths at the anus called anal polyps or skin tags. Firstly it is important to check with a qualified doctor about the correct diagnosis. In most cases of anal skin tags, patients are reassured that no abnormal growth is present and the anus can be left alone. In some cases the tags can cause irritation, anal itching or difficulties with cleaning the area, and it is then possible to excise them surgically in local anaesthesia. Sometimes it is not possible to diagnose an anal lump confidently on examination meaning that an excision biopsy of the lump should be carried out. The lump can then be analysed under the microscope in the laboratory for a definitive diagnosis.
Often skin tags and fibrous anal polyps are not given due importance in the proctology practice. They are mostly ignored being considered as normal structures. Many studies have shown, however, that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic anal fissure.
Symptoms
Anal papillae are found in almost 50-60% patients examined by us in regular practice. Usually, they were small, caused no symptoms, and could be regarded as normal structures.
However, if it is a case of hypertrophy and the papillae projects in the anal canal, it not only requires attention but calls for a suitable treatment also. In such cases, there are
chances of increase in the mucous leak resulting in increased anal moisture. These are liable to get traumatized and inflamed during the passage of stool. In addition, on being converted
into a fibrous polyp, they tend to project at the anal orifice during defecation, often requiring to be digitally replaced. These polyps are considered as one of the differential diagnoses of
rectal prolapse. Symptoms like Pruritus ani”>pruritus, a foreign body sensation, pricking, a nagging sense of incomplete evacuation and heaviness in the anal region are common complaints .
Treatment
As a routine practice, these pathologies were not given any importance. Secondary goals of fissure surgery sometimes required the removal of hypertrophied papilla and skin tag as well as the removal of inflammatory and surrounding fibrotic tissues.
Customarily, pile excision after ligation and electrocautrization has been suggested. All these procedures are time consuming and are associated with complications at times. The use of diathermy devices to deal with these pathologies has been found to be a quick, easy and significant complication free procedure.
