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ANAL
WARTS What
are anal warts?
Anal warts (also called "condyloma acuminata")
are a relatively common and bothersome condition that affects the area around
the anus. They may also affect the skin of the genital area. They first appear
as tiny blemishes, perhaps as small as the head of a pin, and may grow larger
than the size of a pea. Usually, they do not cause pain or discomfort to afflicted
individuals. As a result, patients may be unaware that the warts are present.
Where do
these warts come from?
They are thought to be caused by the human papilloma
virus which is relatively contagious. The virus can be transmitted from person
to person, almost always by direct contact. Do
these warts always need to be removed?
Yes. If they are not removed,
the warts generally grow larger and become more and more numerous. In addition,
there is evidence that these warts can become cancerous if left untreated for
a long time. What
treatments are available?
If warts are very small and are located only
on the skin around the anus, they can be treated with medications, which are applied
directly to the surface of the warts. This method, while relatively simple in
concept, must be carried out with great care and precision by a physician to prevent
injury to the normal skin surrounding the warts. This method usually requires
several applications performed at various intervals over several weeks.
Another
form of treatment involves more rapid destruction of the warts using electrical
cautery, surgical removal or a combination of the two. Laser surgery may also
be used but has no advantage over other treatments. These procedures provide immediate
results but must be performed using either a local anesthetic - such as novocaine
- or a general or spinal anesthetic, depending on the number and exact location
of warts being treated. Warts
inside the anal canal usually are not suitable for treatment by medications, and
in most cases need to be treated by cauterization or surgical removal.
Must I be hospitalized for treatment?
No. Almost always, the cautery
and excision technique can be performed on an outpatient basis, and the patient
can go home after the procedure.
How
much time will I lose from work after a cautery treatment?
This depends
on each individual situation and the extensiveness of warts removed. Most people
are moderately uncomfortable for a few days after treatment, and pain medication
may be prescribed. Depending on the extent of the disease, some people return
to work the next day, while others may remain out of work for several days. Will
a single treatment cure the problem?
Not in most cases, unfortunately.
Even with the cautery and surgical treatments that immediately destroy existing
warts, many patients develop new warts after treatment. This occurs because viruses
that cause the warts can live concealed in tissues that appear normal for up to
six months or longer before another wart develops. New warts will often develop
from the virus that was already present in the tissue, but these are not recurrences
of warts already treated.
As new warts develop, they usually can be treated
in the physician's office, using either a chemical solution or the electrical
cautery procedure. These treatments are performed every few weeks initially, then
less frequently as new warts become smaller and less numerous. Sometimes
new warts develop so rapidly that office treatment would be quite uncomfortable.
In these situations, a second and occasionally third outpatient surgical visit
may be recommended.
How long is treatment usually continued?
Follow-up visits are necessary
for some months after the last wart is observed to be certain that no more warts
occur from viruses living in the cells of skin.
What
can be done to avoid getting these warts again?
In some cases, warts
may recur repeatedly after successful removal, since the virus that causes the
warts often persists in a dormant state in body tissues. Following are tips to
avoid recurrence and reinfection:
Continue observation for several months
after the last wart has been spotted to improve the chances that both the warts
and the underlying virus that causes them have been eliminated. Abstain
from sexual contact with individuals who have anal (or genital) warts. Since many
individuals may be unaware that they suffer from this condition, sexual abstinence
or limiting sexual contact to marriage relationships will reduce your potential
exposure to the contagious virus that causes these warts. As a precaution, sexual
partners ought to be checked, even if they have no symptoms.
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The
executive office of the 1,800-member American Society of Colon and Rectal Surgeons
is located in the Chicago suburb of Arlington Heights. Board-certified colon and
rectal surgeons complete a residency in general surgery, plus an additional year
in colon and rectal surgery. They also pass an intensive examination conducted
by the American Board of Colon and Rectal Surgery administered after successful
completion of written and oral examinations conducted by the American Board of
Surgery.
For
additional information or a list of colorectal surgeons in your area, contact:
American Society
of Colon and Rectal Surgeons
85 W. Algonquin Rd., Suite 550
Arlington
Heights, IL 60005
(847)290-9184 or (800)791-0001
Email: ascrs@fascrs.org
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