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Symptoms and diseases that we treat

Symptoms that we treat

Bleeding from the anus

Bright red blood is commonly from the rectum or the anus, and bleeding from the colon is conceivable if it is reddish black or mixed with mucus. If there is blood on the paper or is dripping, it is generally an anal disorder. If a large mass of blood comes out, it is commonly bleeding from the large intestine. In any case, accurate diagnosis cannot be done unless it is confirmed with an anoscope, rectoscope or colonoscope, etc.

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Swollen and painful anus

If there is swelling around the anus and always throbbing pain, it may a perianal abscess. In this case, there may be fever and pus may come out from around the anus. If it is painful when defecating or afterwards, there may be an anal fissure. If so, sentinel tags may form at the edges of the anus and slight swelling may be seen.
If there is swelling outside the anus like flowers blooming, the hemorrhoid (blind hemorrhoid) has come out and is called an incarcerated hemorrhoid.
A small lump that forms at the entrance of the anus is an anal fistula or thrombotic external hemorrhoid.
In any case, please be examined by a proctologist.

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Severe pain at bowel movement

It may be an anal fissure if there is pain during or after bowel movements, and it does not hurt at times other than defecation. The anal fissure shows bleeding on paper, and bleeding stops when defecation ends.
There are many causes, but it is often due to hard stools, and in most cases it improves with relief of constipation. There is no over-the-counter ointment that is effective for anal fissures. Please get a prescription for an appropriate ointment from the doctor.

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Red stool

You can’t tell whether reddish stool is due to bleeding or diet without a doctor. A stool is taken and examined for fresh blood reaction. If it is positive, it is bleeding.
First of all, there is probably bleeding somewhere between the mouth and the anus. If bleeding is from the esophagus, stomach or duodenum, the stool becomes like black coal tar. If bleeding is from the large intestine, stool will be thick and mixed with reddish black mucus. If bleeding is from the rectum or anus, stool will be bright red sometimes mixed with mucus.
If you are concerned about reddish stools, be sure to consult a doctor. It could even be a malignant tumor (cancer), so self-judgment is not an option.

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Feeling itchy around the buttocks

The skin around the anus is weakly acidic, and itches if in contact with feces of diarrhea (which is alkaline). Also, the cause can be a flap of skin called a skin tag, which itches as if feces were stuck there. In addition, an anal fistula may open a hole in edge of the anus, from which pus comes out, making the surroundings itchy.
Occasionally, it may become itchy for no apparent cause. Please consult a doctor as treatment could become unexpectedly prolonged.

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Oozing from buttocks

The complaint of “oozing” is divided into a feeling that undergarments are dirty and a feeling of dampness.
Causes are divided into cases where the buttocks are loose and cases of prolapsed lesions such as blind hemorrhoids from the anus. Also, there are cases where there is no clear lesion, and a manometry examination and diagnosis by a specialist are necessary.

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Feeling of incomplete evacuation

A feeling of incomplete evacuation can result from stool remaining in the anus, or from blind hemorrhoids. The same symptoms can occur if there is irritation in the rectoanal region. Please consult a doctor because it can also be rectal cancer.

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A swelling on the buttocks

If there is a kind of hard lump around or at the edge of the anus, it could be an anal fistula, thrombosed external hemorrhoid or skin tag (flap of skin). If coming out of the anal hole, it could be blind hemorrhoids, anal polyps, rectal cancer, rectal polyps or other, but you should not ever judge it yourself. A diagnosis by a doctor who is proficient in proctology practice is required.

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Mucus from the buttocks

If mucus is mixed with blood, it is necessary to diagnose where the bleeding is from. It could be colorectal cancer, so a doctor’s diagnosis is needed.

If mucus is transparent white, lesions in the anus (such as anal prolapse, rectal prolapse) are possible. For accurate diagnosis of the anal region, diagnosis of a proficient proctologist is necessary.

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Feeling that something is stuck

If there are blind hemorrhoids, rectal cancer, anal polyps, etc. in the rectoanal region, there is a feeling that remaining feces is always stuck. If there is inflammation in the rectum or inflammation at the exit of the anal gland, there will be a strong feeling of residual feces.
Diagnosis by a proctologist is necessary for accurate diagnosis.

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Anal prolapse

This means that the anus is slipping backward. There may be blind hemorrhoids, rectal prolapse, rectal cancer, polyps of the rectum anal region, etc.
Although it tends to be neglected because it does not hurt, if you receive appropriate treatment under the accurate diagnosis of a doctor, the prolapse will heal so that a comfortable life can be guaranteed.

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Comes out and doesn’t go in.

It happens that a prolapsed blind hemorrhoid or rectum will not return. Rarely, it may be due to rectal cancer or rectal polyps. Since the prolapsed tissues may decay and cause major bleeding or severe pain, prompt treatment is necessary. Please consult a doctor immediately.

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Constipation

The defecation is not the work of the anus alone, the function of the colon is also important. If one or both of these functions worsen and bowel movements become poor, feces will accumulate in the rectum.
Causes include muscle weakness and relaxation of the rectoanal region due to aging, hypertonic muscles lifting the anus, colorectal cancer (rectal cancer etc.), rectocele and anal stenosis.
If feces will not come out no matter how hard you breathe, please visit our clinic. Feces will be evacuated properly. It is important that a doctor familiar with it performs.

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Blood on toilet paper

After defecation in the toilet, red blood may stick to the toilet paper. If it is bright red, it is probably bleeding from the rectoanal region. If it is reddish black and mixed with mucus, it is often bleeding from the large intestine and an endoscopic examination is necessary, so please consult a doctor.
Neglecting it by simply thinking that it is hemorrhoids is no laughing matter if it is actually colorectal cancer. Please consult a doctor promptly.

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Blood is dripping

If bright red blood drips after defecation, it is bleeding from the rectoanal region. Please consult a doctor as it may be a rectal cancer. If there is blackish red blood, it could be an inner colorectal cancer, and an endoscopic examination is necessary.

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Discharge of pus around anus

If the area around the anus is swollen and becomes very painful, and there is a hole in the swollen area from which pus comes out, it is an anal fistula. A swollen condition is called a perianal abscess, but it is the same disease as an anal fistula.
In the case of an anal fistula (perianal abscess), surgical treatment is often necessary, and consultation with a doctor is needed. Data showing that 30% of anal fistulas are cured just by incision and drainage has been published at academic conferences, but in reality, most anal fistulas are difficult to cure completely and recur.
In our clinic, we use the seton technique. Since there is no need for hospitalization and there are few complications such as recurrence and sphincter deficiency, concerned people should definitely visit.

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No bowel movement despite straining

Being unable to defecate no matter how much you strain in the toilet is called defecation difficulty (dyschezia). It may be simple constipation, but if it becomes a normal state a specialist’s diagnosis is needed.
In order to learn the cause of defecation difficulty, it is necessary to perform rectoanal function tests such as an anal sphincter muscle force test (manometry), defecation contrast examination (defecography), colon fiberscope or Sitzmarks test.
We can perform these examinations at our clinic, so please do not hesitate to visit us if so desired.

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Narrow stools

In bowel movements, if you feel that your stool has become thin all the time recently, please consult a doctor. When the anus narrows, the stool becomes thinner, but the possibility of colon cancer cannot be excluded.

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Severe diarrhea

When transient diarrhea is severe, acute diarrhea should improve by symptomatic treatment with medicine.
If diarrhea persists for several months or years, detailed examination is necessary. Recently, irritable colitis due to stress is increasing. Crohn’s disease and ulcerative colitis are increasing, so a doctor should be consulted.

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A lump around the buttocks

There are cases of a lump immediately near the anus, and cases in a place slightly removed from the anus.
In the former, they may be thrombosed external hemorrhoids, hardened skin flaps, or a malignant tumor, etc. In the latter, possibilities include perianal abscess, anal fistula, atheroma, follicular cyst, and pyoderma.

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Heavy pain in the buttocks

The diagnosis will vary depending on the condition in which heavy pain occurs. When in the same posture, for example standing or sitting down, and the anus is painful inside, or if it hurts after going to the toilet, it is most likely internal hemorrhoids, and a diagnosis will follow after anoscopy is performed. If the anus is heavily painful inside regardless of posture or defecation, there may be surrounding abscesses or anal fistulas. Sometimes an anal fissure may cause heavy pain after bowel movements.
In any case, it cannot be known for sure without an examination.

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The buttocks hurt like an electrical sensation

If it hurts as if electricity runs in the buttocks, when does it hurt? Does it hurt all the time? The diagnosis differs if it hurts at a certain time, such as nighttime.
In the case of pain “generally, as if electricity is running”, it often runs the course of pudendal neuralgia, which often is a symptom of sacral nerve syndrome, but examination by a proctologist is necessary.

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Leakage of feces or gas

Symptoms may appear due to aging or to transient or chronic anal looseness due to past anal disorders. This is called “anal sphincter insufficiency”, and our clinic conducts rehabilitation to improve such problems. Rehabilitation with a nurse once a month gets certain results, and many patients are pleased. Improvement has been seen in 70 to 80% of patients in about three months.

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Diseases that we treat

Internal hemorrhoids

Straining at the toilet, congestion develops in the anus. A blood vessel (vein) can be blown up like a wart. Bleeding and prolapse are the major symptoms, accounting for many hemorrhoids. (Figure 1 below)

1. Bleeding without prolapse ® Suppositories, Paoscle injection (hardening) therapy, etc.
2. Bleeding and prolapse, but returns spontaneously ® Four-step injection therapy (ALTA)
3. Bleeding, prolapse put in with finger ® Surgery (classical ligation therapy), Four-step injection method (ALTA) (See separate reference.)
4. Bleeding, prolapse remains ® Surgery (classical ligation therapy) (See separate reference.)

Suppositories used are steroid or non-steroid suppositories according to their characteristics for acute, subacute and chronic phases. In order to prepare bowel movements, laxatives, antidiarrheal medicines, antiflatulents, and herbal medicine are used.

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Surgical method for internal hemorrhoids

Our clinic does not cut internal hemorrhoids (blind hemorrhoids). They are tied with a special string to make them decay and drop off. It sounds painful, but a special anesthetic is injected to the anus. Then there is little pain. Since the anus is not cut, the sphincter muscles are not cut, so of course there will be no leakage of stool or undergarment stains. This treatment (classical ligation therapy) has a long history and its safety and benefits have been confirmed.

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External thrombosed hemorrhoids

A round wart with tenderness is formed near the exit of the anus.
The content of warts is a mass of blood, but it involves pain.

Treatment methods include steroid suppositories and anti-inflammatory analgesics, along with improvement of bowel habits.
If there is no improvement or repeat recurrence, thrombectomy + external hemorrhoidectomy surgery will be performed. (See separate surgical methods.)

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Surgical method for external thrombosed hemorrhoids

At our clinic, we use a CO2 laser to make outer hemorrhoids (warts made outside) as small as possible and remove them. We have adopted this method because there is little pain after surgery, and little bleeding. Hospitalization is not needed.

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Anal fissure

Anal fissures occur due to hard stool or severe diarrhea.

It is tear in the skin near the anus.

Symptoms are bleeding during and after bowel movements, and blood on the toilet paper.

As a rule, surgery is rare.

Most people get better with the improvement of bowel habits (constipation, diarrhea).
However, surgery is used in chronic cases or complication by anal stricture. (See separate surgical methods.)

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Surgical method for anal fissure (2)

With repeated anal fissures or watery stool is repeated for many years, the anus is narrowed. When the narrow anus becomes fixed, the condition in which an anal fissure develops is repeated.
In bowel movements, it is important to adjust the hardness of stool from hardness like toothpaste to hardness like a banana.
It is also important to expand the narrowed anus. At our clinic, we perform an operation called a sliding skin graft, which in principle is a one-day surgery carried out in a body-friendly manner with minimal invasiveness.

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Anal fistula

Something like a boil appears around the anus and pus comes out. Symptoms include “The inner anus is heavy and painful”, “There is pain regardless of defecation” and “There is constant pain”.
There is tissue called the anal gland (whose function is still not well understood) that secretes mucus, located slightly within the anus exit. Bacteria enter this anal gland and pus accumulates with swelling as infection occurs. When swelling reaches the maximum, a hole is formed in the skin or mucosa, and pus is discharged.
At our clinic, MRI (T2-weighted, fat suppression, sagittal image combined) imaging diagnosis is performed to confirm the course of the anal fistula. We conduct this exam before surgery in order to gain accurate data to carry out appropriate surgery, and after surgery to know whether the anal fistula is cured.
We believe that this disease will not be cured without surgery.

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