Anal polyps: Specialists & information

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Anal polyps are tissue growths that can develop from natural small folds at the junction between the rectum and anus. They are always benign and can remain symptom-free. In the case of particularly large anal polyps, removal using an electric sling is advisable, as they can impair the function of the sphincter muscle.

Here you will find further information as well as selected specialists and centers for anal polyps.

ICD codes for this diseases: K62.0

Recommended specialists

Brief overview:

  • What are anal polyps? Small tissue growths on the anus that are always benign. Under certain circumstances, however, the function of the sphincter muscle may be impaired.
  • Differentiation: It is not clear to the layperson whether it is an anal polyp, haemorrhoids, mariscus, anal thrombosis or a tumor. Careful clarification is necessary.
  • Symptoms: Foreign body sensation, pain, blood when going to the toilet, stool smearing, itching and skin inflammation.
  • Causes: Irritation, inflammation, diseases of the anus, surgical interventions and injuries to the anus and rectum can stimulate the formation of anal polyps.
  • Diagnosis: The doctor makes a suspected diagnosis based on the patient interview and subsequent physical examination. The diagnosis is confirmed by means of anal endoscopy and, if necessary, a biopsy. Other procedures are rarely used.
  • Treatment: Anal polyps can be removed quickly and painlessly using an electric snare. Bleeding usually stops a few days after the procedure.
  • Aftercare: A high-fiber diet supports soft bowel movements. The anus should only be cleaned carefully with water. Anal polyps may form again.
  • Prevention: A balanced diet rich in fiber and fiber is the best prevention against anal fissures and inflammation, which can cause an anal polyp to develop.

Article overview

Definition: What are anal polyps?

Anal papillae are naturally found at the junction between the rectum and anus. These are leaf-shaped protrusions of the mucous membrane.

These mucosal protrusions can occur after

  • operations,
  • injuries or
  • certain diseases

up to a size of several centimetres and protrude into the anal canal or even out of the anus. Enlarged anal papillae (also known as hypertrophied anal papillae) are then referred to as anal polyps or anal fibroids.

Anal polyps can be as small as a grain of corn or the size of a cherry.

Although they are tissue growths, they are always benign and not dangerous. You therefore do not need to worry that these growths could degenerate into cancer.

However, if they are large enough, they can lead to the anus no longer closing completely. This is indicated by wet patches in the underwear.

Forms: Anal polyp or a hemorrhoid?

Anal polyps have similar symptoms to hemorrhoids. As a result, the layperson is usually unable to recognize which of the two diseases is present. The symptoms of both diseases include

  • Oozing,
  • itching,
  • pain,
  • bleeding and
  • lump formation.

However, there are also other clinical pictures, such as

which can have similar symptoms.

A careful and ultimately reliable diagnosis is therefore of the utmost importance for effective treatment.

Symptoms: Depending on the size

As long as the anal polyps are still small, they generally do not cause any symptoms.

A large anal polyp also impairs the fine mechanism that regulates the closure of the anus. Therefore, the larger the polyp, the greater the discomfort. This can lead to the following symptoms:

  • Foreign body sensation in the anus,
  • Pain, especially during bowel movements,
  • Blood on the stool or on the toilet paper,
  • oozing, stool smearing and fecal incontinence and, as a result, soiled underwear,
  • itching and skin inflammation around the anus due to stool leakage.

If a larger anal polyp slides out of the anus, it must be pushed back in by hand. It will not retract on its own.

Causes and risk factors

Anal polyps can occur in all people. Risk factors for the enlargement of the pinhead-sized anal papillae are

  • Irritation,
  • Inflammation and diseases in the anus,
  • surgical interventions and injuries to the anus and rectum.

Anal fissures (tears in the mucous membrane in the anal canal) are relatively common causes of the growth of anal papillae and thus anal polyps.
Analfissur
Localization of anal fissures in the anus © bilderzwerg | AdobeStock

Examination and diagnosis

Specialists for diseases of the rectum, i.e. the rectum and anal canal, and therefore also for anal polyps, are called proctologists. However, gastroenterologists are also considered experts in anal polyps.

During the anamnesis (patient interview), the doctor will inquire about your complaints. During the inspection (examination) of the anus, the proctologist will look for abnormalities such as lumps or inflammation.

If necessary, the doctor will ask you to push so that the anus can be assessed even more closely. He will examine the anal canal with his finger(digital rectal examination). This allows the doctor to feel for nodular or scarred changes.

The best way to detect and assess changes in the anal canal is with a proctoscopy (rectoscopy). A proctoscope is a short tube with a light source and optics that is inserted into the anal canal via the anus. This examination also allows the origin of the tissue growth to be identified.

For example, the proctologist can assess whether it is a hemorrhoid or an anal polyp. If there is any doubt, but also to confirm the suspected diagnosis, a biopsy (removal of a tissue sample) is carried out. The tissue sample is then examined in the histology department. In this way, benign tissue changes can be distinguished from malignant ones.

Only in rare cases and to exclude or confirm other diseases are further examinations carried out, such as

General information on treatment

Not every anal polyp needs to be treated. It is recommended that only those enlarged anal papillae that are causing symptoms are treated.

The histological examination may also reveal that it is a tissue change that could become malignant. In this case, the doctor will probably advise you to have an operation.

However, the doctor should check all other tissue neoplasms that do not require treatment at regular intervals. This will enable them to detect changes in good time.

Cutting with electricity

Anal polyps can be removed on an outpatient basis with minimal pain. The doctor removes them using a laser or an electric snare (so-called high-frequency diathermy snare). Anal polyps are removed under local anesthesia.

During anal polyp surgery using an electric snare, the surgeon places the snare around the polyp. An electric current is then applied to the snare and carefully tightened. The anal polyp is cut off at its base by the electric shocks.

Elektroschlinge bei Darmpolypen
Intestinal polyps (like here) and anal polyps can be easily removed using an electric snare © SciePro | AdobeStock

See a doctor in case of severe complications

Surgical pain and bleeding can occur during and after the removal of anal polyps. Postoperative bleeding usually stops within a few days. You will be given a painkiller to relieve the pain in the first few days after the operation.

However, if you experience severe pain after the operation

  • experience severe pain,
  • bleed more heavily or
  • the bleeding does not stop after the operation,

you should definitely see your doctor to find out the cause of your symptoms.

After the operation

Depending on the cause of the anal papilla, it may take some time (sometimes even several weeks) for the wound to heal.

You can support the healing of the wound by ensuring that your stool is smooth by eating a diet rich in fiber . The doctor may also recommend a mild laxative for the first few days. You should only use water and no soap or similar to carefully clean the anus after each bowel movement.

If you suffer from recurrent inflammation in the rectum, anal polyps can develop again. However, they can then also be removed again.

Prevention

Anal polyps often develop as a result of inflammation or injury in the rectal area. Therefore, any inflammation or disease (for example an anal fissure) must be treated. On the other hand, you should make sure that such underlying conditions do not develop in the first place.

If you prevent the development of an anal fissure, you also reduce the risk of developing an anal polyp. The best way to prevent anal fissures (and therefore anal polyps) is to ensure that your bowel movements are not too hard, but also not too soft. Your diet should therefore be balanced and rich in fiber.

References

  • Joos AK et al. (2019) Leitlinien der Deutschen Gesellschaft für Koloproktologie. S3-Leitlinie - Hämorrhoidalleiden. AWMF-Registriernummer: 081/007.
  • Lenhard B (2002) Leitlinien der Deutschen Dermatologischen Gesellschaft: Hypertrophe (vergrößerte) Analpapille. AWMF-Registriernummer: 013-011p.
  • Helmes C, Pakravan F (2010) Proktologie: Die Diagnose „Hämorrhoidalleiden“ wird zu häufig gestellt. Dtsch Arztebl 107(5): A-182 / B-160 / C-156.
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