Anal Warts

What are anal warts?

Warts are developed around or inside the anus. At the initial stage, the structures of the warts are rounded spots or projections similar to as head of a pin. The numbers of anal warts increases very first and may spread to entire rectal area. In initial stage, affected individual is usually unaware of the development of the warts as they are asymptomatic, but when they spread, some individuals may having feeling of itching or bulge or bunch in the anal area.

Symptoms of anal warts

Due to asymptomatic nature of the anal warts, often their development is ignored. These warts do not cause any pain or related uneasiness.

Initial development of warts is so small that they cannot provide any responsiveness. When the number and size is increased, then they clustered together and look like cauliflower.
The color of the warts may be pink, yellow or light brown
Some cases the appearance of the warts are like flesh like structure
The responsible virus also affects other genital parts and warts are developed in other parts of the body also.
The virus can affect and develop the warts on the oral cavity.
The affected female genital organs include vagina, vulva and cervix.
The affected male genital organs include the scrotum, penis, groin and thighs.
Rarely, it also reported that anal warts cause itching, mucus discharge, bleeding.
Some individual also feels lump like structure in the anal area.

Causes

Human papilloma virus (HPV) is responsible for development of the anal warts. This virus can transmit via skin to skin contact from affected partner to non affected partner, so sexual intercourse is not only the prime reason, any contact with the anal area via hand or get in touch with the genital discharges can cause anal warts development. Within three months, after intimate contacts with affected partner can develop warts, but sometimes, it takes more than year.

Diagnosis

Patient medical history and sexual life style discussion is part of diagnosis. Incidence of some disease like rheumatoid arthritis, organ transplantation and inflammatory bowel disease cause impaired immune system. Anal intercourse increases the risk of onset of anal warts.
Anal wart is diagnosed by visual examination during physical check up of pelvic region. To make the warts more prominently visible, application of acetic acid causes the bumps to becomes whiter in colour. This examination cannot detect Human Papiloma Virus (HPV).

Anoscope is a medical instrument use to examine the internal warts present inside the anal canal. This device also assists to detect the other genital warts.
For women, speculum examination is also conducted for vaginal check up.
For rule out of any mass growth, digital rectal examination is done.
In case of women, Pam smear test is also recommended for conduction.
If the condition is prolonged and worsens with time, then HIV test is also recommended.
Biopsy of warts is also conducted, if the usual therapy is unable to provide any effective result.

Treatment

The treatment is dependent upon the number of warts, affected region, the doctor’s choice and patient preference. The available treatment for anal warts is as follows:

Topical medicaments are prescribed for small sized anal warts. The drugs like trichloroacetic acid, podophyllin, podofilox, imiquimod and bichloroacetic acid are commonly available as cream or ointment formulation. These medicaments are easy to apply, but some burning sensation may be felt by the patient after application of the medicaments. The duration of treatment may lasts for several weeks to months. The efficacy of the drugs is not similar with all the patients, so the result of the treatment is not providing clear view. The included side effects like itching, skin irritation, progression of ulcer, pain or burning sensation is progressed, then it is recommended to stop the medication immediately.
Cryotherapy: In doctor’s clinics, the application of liquid nitrogen provides freezing effects to the warts and causes development of the blister like structure around the warts. After sometimes both warts and blister fall offs and gradually skin become heal.
It is always recommend taking advice from the doctors after onset on anal warts. It may be an initial stage of anal cancer.
This is also suggested that OTC products for wart removers are not intended to use for anal warts.
Some medicament need medical assistance and that should be applied under medical supervision at the doctor’s clinic. Others can applicable at home also; those are not having frequent incidence of side effects or produce less discomfort.

Surgical Treatment

In case of larger sized warts, the topical application is not effective. For them surgical intervention can help to treat the warts. In case of small wart, the surgery procedure comes under minor surgery and conducted under local anesthesia. For this surgery, patient need not to admit in the hospital, this is conducted on a day care or an OPD. In case of extensive warts, general and spinal anesthesia may be applied. The included surgical treatments are:

Electrocautery: The electric current is applied for burning the warts.
Laser Treatments: In this technique light rays are applied for removing the warts.
Fulguration: This is also a technique for burn out the warts.
Complete surgical removal: This is also conducted for some cases where complete removal of warts is needed and surgical excision is conducted.

References

http://www.colonrectal.org/services.cfm/sid:6603/Anal_Warts_(Condyloma)/
https://www.fascrs.org/patients/disease-condition/anal-warts
http://www.healthline.com/health/anal-warts#Symptoms4
Can I Prevent Myself From Getting Warts?, Do These Warts Always Need To Be Removed?, How Much Time Will I Lose From Work After Surgical Treatment? What Can Be Done To Avoid Getting These Warts Again? at https://www.fascrs.org/patients/disease-condition/anal-warts-and-anal-dysplasia-expanded-information