Proctology

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What they are: Swollen and inflamed blood vessels underneath the surface of the anal canal.

How they arise: Increased pressure—often from straining during bowel movements, chronic constipation or diarrhoea, pregnancy, or sitting for long periods—causes these veins to engorge and stretch the lining of the anal canal. 

Symptoms: Bright red rectal bleeding, anal itching, discomfort, or a palpable lump at the anus.

Treatment options:

Non-operative: Avoid surgery with bespoke lifestyle advice

Minimally invasive clinic procedures: injection sclerotherapy, rubber band ligation

Surgery: open haemorrhoidectomy, ligasure haemorrhoidectomy, HAL-RAR (haemorrhoidal artery ligation and recto-anal repair) 

What they are: Small tears in the lining of the anal canal.

How they arise: A tear due to the passage of hard stool, leading to a vicious circle; severe anal pain causing spasm of the anal sphincter, leading to poor blood supply, which stops healing, resulting in ongoing pain and further spasm, etc. 

Symptoms: Sharp pain during and after bowel movements, bleeding, and sometimes a small skin tag (“sentinel pile”) at the fissure site.

Treatment options:

Medical

Botox® injections

What they are: Small, benign flaps of excess skin that protrude from the anal margin. 

How they arise: As swelling from haemorrhoids recedes, the overlying skin can remain stretched and form a tag.

Symptoms:

o Usually asymptomatic and discovered incidentally.

o May cause hygiene challenges, trapping of stool or debris.

o Can lead to itching, mild discomfort, or a sensation of fullness at the anus.

Treatment options:
Non-operative: Avoid surgery with bespoke lifestyle advice

Minimally invasive clinic procedures: injection sclerotherapy, rubber band ligation

Surgery

 What they are: Small, benign flaps of excess skin that protrude from the anal margin. 

How they arise: As swelling from haemorrhoids recedes, the overlying skin can remain stretched and form a tag.

Symptoms:

o Usually asymptomatic and discovered incidentally.

o May cause hygiene challenges, trapping of stool or debris.

o Can lead to itching, mild discomfort, or a sensation of fullness at the anus

Treatment options:
Non-operative:Avoid surgery with bespoke lifestyle advice

Minimally invasive clinic procedures: injection sclerotherapy, rubber band ligation

Surgery

 What it is: A localized collection of pus in the anal or rectal area.

How it arises: Infection of an anal gland leads to accumulation of pus.

Symptoms: Severe pain, redness, swelling, sometimes fever or chills.

Treatment options:

Urgent drainage (in-clinic or operating room) to relieve pain and clear infection.

Antibiotics: Sometimes used alongside drainage, especially if cellulitis or systemic signs are present.

What it is: Intense itching around the anus.

How it arises: Skin irritation from moisture, hygiene products, incomplete cleaning, haemorrhoids, or fungal infections.

Symptoms: Persistent itching, redness, sometimes pain from scratching.

Treatment options:

Non-operative: Avoid surgery with bespoke lifestyle advice