Colorectal Surgery and Services

An anal fissure is a split in the tissue that lines your anal canal causing pain or bleeding, especially during bowel movements. Anal fissures can be common in infants and pregnant people. A visit with a colon and rectal specialist will help diagnose an anal fissure through a physical exam.

Treatment

Most anal fissures go away on their own or with prescription cream. If an anal fissure is present for an extended period of time, medical interventions such as surgery may be needed.

An anal fistula is an infected tunnel that develops under the skin between the skin of the buttocks and anal canal in the colon. This condition is a reaction due to infection that starts in an anal gland and results in an abscess (puss-filled infection). A tunnel forms under the skin connecting to the infected gland, forming an anal fistula.

Some conditions such as Crohn’s disease, Colitis, chronic diarrhea and radiation treatment for rectal cancer can affect the lower digestive tract and increase the risk of developing anal fistula.

Diagnosis

An anal fistula may not always be visible, as they can close on their own and then reopen. A visit with a colon and rectal specialist will help diagnose an anal fistula through a physical exam, imaging tests or a colonoscopy.

Treatment

Surgery is the best treatment for an anal fistula as there are currently no medications to cure it. Antibiotics can help treat an anal fistula, but surgery is the most effective treatment in curing the condition. There are various surgical treatment options depending on the location and severity of anal fistula.

An anal abscess develops when a collection of pus forms near the anus. Often these are a result of infection from small anal glands. A visit with a colon and rectal specialist will help diagnose anal fissure through a physical exam and screening for sexually transmitted infections, inflammatory bowel disease or diverticular disease.

Treatment

Surgical drainage of the abscess is important before the abscess erupts. Medications or antibiotics may also be prescribed.

Anorectal disease is the name given to a group of conditions of the anus or rectum that are often painful. Most commonly, these conditions include hemorrhoids, anal fissures, anal warts, anal fistulas and anorectal abscesses, and more.

Depending on which condition you might be experiencing, you will need a physical exam and likely an endoscopic examination of the lower colon, rectum and anus. Treatment options for anorectal disease usually include dietary and lifestyle changes, physical therapy or surgery for more persistent infections and symptoms. Treatment and recovery depend on the type and severity of the condition.

Our colorectal surgeons collaborate with a multidisciplinary team of gastroenterologists, urologists, urogynecologists, interventional radiologists, physical therapists, and pain psychologists to address the complex causes of chronic pelvic pain.

Through our comprehensive approach, we hope to establish long-term relationships with those suffering from chronic pelvic pain to provide early intervention as well as long-term management and support.

Treatment

Treatments may include anti-inflammatory and/or pain medicines, relaxation exercises, physical therapy, or surgery. Depending on the cause or severity of the pelvic pain condition, patients may be referred to a gastroenterologist, urologist, urogynecologist, interventional radiologist, physical therapist, or pain psychologist.

For more information about colorectal surgery support for pelvic pain, or to make an appointment call 203-785-2616.

We offer cancer genetic counseling and testing, and cancer screenings. Genetic counseling provides comprehensive risk assessment, education and screening for patients at increased risk of colon cancer. Cancer screening tests help diagnose cancer as early as possible before symptoms arise. Some of these cancer-screening tests detect potential problems; allowing doctors to treat them right away. Our team of genetic counselors, nurse practitioners and physicians work together to create a personalized care plan for each patient. Patients identified as being at increased risk can choose to be followed in the Colon Cancer Prevention Program.

We offer cancer genetic counseling and testing, and cancer screenings including colonoscopy, CT Colonography, Sigmoidoscopy and stool-based tests.

Learn more about colon cancer prevention

Physicians in the Center for Gastrointestinal Cancers at Smilow Cancer Hospital and Yale Cancer Center care for patients with cancers of the esophagus, stomach, liver, pancreas, colon, bile ducts, rectum, appendix and anus.

Learn more about Colorectal Cancer

Yale New Haven Health offers a comprehensive Inflammatory Bowel Disease (IBD) Program. Our IBD Program offers a unique team-based approach that includes the patient, family members and caregivers.

Learn more about Inflammatory Bowel Disease

Diverticulitis occurs when small, bulging pouches within the digestive tract become infected or inflamed.

Learn more about diverticulitis

Fecal Incontinence, also known as anal incontinence, is the passage of gas or feces without control. Normally continence occurs through the interaction between sensory nerves, sphincter muscle control, pelvic floor muscular coordination, and stool consistency. When one or more of these elements fail, incontinence can result.

This condition can occur when experiencing diarrhea and is typically chronic or recurring. It can also occur in people who may not be aware that they need to pass a stool. The most common cause is prior to obstetric trauma, but there are many other possible causes including sphincter damage from prior surgery, nerve damage to the pelvic floor, or hemorrhoids.

Diagnosis

Thorough examination and visual inspection are performed to diagnose fecal incontinence, along with various tests to help determine the cause.

Treatment

Initial evaluation and treatment begin with a thorough history and exam, along with measures such as diet change, stool bulking, exercises or therapies, and antimotility medications. Patients who do not respond to initial approaches may need additional testing such as manometry or ultrasound evaluation of their sphincter complex. Successful surgical treatment depends on the underlying cause.

Hemorrhoids are a normal part of our anatomy and are located internally and externally around the anal canal and the anal opening. Hemorrhoids are recognized when bleeding, protrusion or itching occurs. In a normal state, they cause no symptoms.

Diagnosis

Your doctor can diagnose hemorrhoids through a rectal exam. A short-lighted probe, called an anoscope, may be used to examine the inside of the anal canal where internal hemorrhoids are located. Some cases might need a colonoscopy to ensure symptoms are not related to a more serious condition in your rectum or colon. A colonoscopy may be needed to ensure symptoms are not related to a more serious condition in your rectum or colon.

Treatment

Most hemorrhoid symptoms improve with dietary and lifestyle changes or with medication. Other alternatives are rubber band ligation, infrared coagulation, sclerotherapy and surgical hemorrhoidectomy. Typically, hemorrhoids do not need surgery because as the blood clot dissolves, the external hemorrhoid will shrink.

They also perform surgical procedures for a permanent ostomy bag, if needed, and refer patients to the Ostomy Program for post-operative care and management.

Learn more about Ostomy Programs in your location:

• Bridgeport Hospital
• Greenwich Hospital
• L+M Hospital
• Westerly Hospital
• Yale New Haven Hospital

Pruritus ani, or anal itching, is a common skin condition characterized by itching or burning around the anus. Many things including irritants or fecal incontinence and long-term (chronic) diarrhea can irritate the skin, causing anal itching. Infections, skin conditions and other chronic conditions such as diabetes, thyroid disease, hemorrhoids and anal tumors can cause Pruritus ani.

Diagnosis

A physical or digital rectal exam may be required. Persistent anal itching could be due to a skin condition or other health issue that will require medical treatment.

Treatment

Through examination and a review of your medical history and habits, a doctor will be able to diagnose the cause of itching. Treatment for anal itching depends on the source of the irritation. Anti-itch creams or treatments for an infection are common.

 Rectal prolapse occurs if the rectum moves from its normal place within the body and pushes out of the anal opening. This can happen due to weakening of the muscles supporting the rectum.

 Treatment

 Treatment can start with steps to avoid constipation and straining. If your rectal prolapse is severe, your healthcare provider may recommend surgery.

A rectocele is a type of prolapse where the supportive wall of tissue between a woman’s rectum and vaginal wall weakens. Without the support of the pelvic floor muscles and ligaments, the front wall of the rectum moves and bulges into the vagina, or in severe cases, protrudes out of the vaginal opening.

Treatment

Depending on the patient's condition, a colorectal surgeon, gynecologist or urogynecologist  will recommend the most appropriate treatment, which can include pelvic floor exercises and bowel training. More serious cases are often treated with a vaginal pessary (a support device inserted into the vagina) or rectocele repair (a minimally invasive surgical procedure).

For more information about colorectal surgery support for rectocele, or to make an appointment call 203-785-2616.