Anal warts - papilloma

What are anal warts?

Anal warts are flat and fleshy growths around the anus that are caused by the Human Papilloma virus (HPV). They are also called anogenital warts or condyloma acuminata. They are also found near the opening of the vagina, under the foreskin of the penis, on the shaft of the penis, over the skin of the scrotum and the area around the anus and along the vagina, cervix and urethra.

What causes anal warts?

Anal warts are caused by Human Papilloma Virus (HPV), particularly genotypes 4 and 11.

How does one get the virus?

HPV infection is contracted chiefly by sexual activity
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Powerful agent against hemorrhoids and rectal fissures

How common are anal warts?

Anogenital warts are the commonest sexually-transmitted viral infections in the United States. Both males and females can be affected but patients are mostly females (67% of patients). Symptomatic warts can be seen in about 1% of the population aged 15 to 49 years.

What puts one at risk of anal warts?

Risk factors for anal warts include early age at first sexual activity, multiple sexual partners and having had other sexually transmitted diseases before. It is not necessary for a person to have had penetrative sex to get anal warts. The virus can cross from skin to skin.

What are the symptoms of anal warts?

  1. They may be asymptomatic
  2. Bleeding
  3. Pain
  4. Itching

Supposing it is not really an anal wart, what else can it be?

Conditions that have similar appearance or symptoms to anal warts include:

  1. molluscum contagiosum
  2. fibroepithelial polyps
  3. vulvar papillomatosis
  4. condylomata lata (secondary syphilis)
  5. invasive cancer

How can anal warts be treated?

Self-Treatment

Podophyllotoxin: This medical cream should be used twice daily, 3 times weekly, followed by a 4-day rest period. This is repeated weekly for 4 weeks.

Treatment in the hospital:

  1. 90% to 99% trichloroacetic acid (TCA) is used for small and separate lesions and the treated area is washed twice a day
  2. Cryotherapy using nitrous oxide or with liquid nitrogen directly. It is applied weekly
  3. Surgical methods include curettage, electrosurgery, and use of a scalpel under anaesthesia (local or general)

An anal fissure is a tear in the skin of the anus which may extend to the muscle of the internal anal sphincter. When this happens, the muscle contracts and the tear will not heal up easily because it is open. Furthermore, faeces soil the wound and delay healing. This will cause pain for the patient.

Up to 20% of people may have anal fissure at some point in their lifetime.


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