Anal Warts. A Visit With The Proctologist.
Anal warts. Also known as condyloma acuminata, are small, fleshy lumps that can grow on any body part, but especially in warm moist areas. Caused by the human papilloma virus, abbreviated HPV, these small warts can be embarrassing at least, and may cause anal cancer at worst. What can be done if you have a HPV or condyloma infection in Los Angeles, West Hollywood or anywhere in the United States? Can a proctologist help?
What Is This Virus? Are There Different Strains?
HPV is a small transmissible virus and can be spread through sexual activity or other contact activities. Although there are more than 200 strains (or genotypes) of HPV, four of the genotypes, 16, 18, 33 and 35 are known to place patients at risk for cervical or anal cancer. A person can be infected with these strains without showing any visible lesions. Cervical Pap smears for women and anal Pap smears for those having anal intercourse may detect early signs of the infection and allow for intervention. Genotypes 6 and 11 are the subtypes which cause 90% of visible warts. These are not necessarily associated with the development of cancer. But, you may be infected with more than one genotype.
The best first method of treatment is prevention. A vaccine, Gardasil,® is protective against genotypes 6, 11, 16 and 18. Condoms can help prevent skin to skin contact and transmission. They are not 100% foolproof however.
Treatment With Medications.
Several approaches exist for the treatment of established disease. There are various forms of topical treatments, all with variable success rates and long term cure rates.
- Podophyllin, and various commercial forms of podophyllin, are resins that can eradicate the warts.
- Trichloroacetic abbreviated TCA, can also remove warts.
- Imiquimod, also known as Aldara®, is an immunomodulator and can stimulate your immune system in areas where it is placed, and may eradicate the warts. Treatment usually lasts over a 6 week period.
It is not clear as to the true effectiveness of these therapies. However, in patients with large loads of anal warts, the wart load my be decreased with these topical preparations, making any necessary surgery less extensive.
When All Else Fails.
As a final resort, operative removal and fulguration may be required. Usually, during the procedure, biopsies are taken to determine which genotypes are involved. The operation is performed as an outpatient. The post operative period is rather uncomfortable but can be lessened by using long lasting local anesthetics injected at the time of the operation, followed by the use of non-steroidal anti-inflammatory medications. Patients must be followed for a prolonged period of time to check for recurrences. If found early, recurrences can be treated in the office setting.
Los Angeles Colon and Rectal Surgical Associates
The proctologists (also known as colon and rectal surgeons, or coloproctologists) of Los Angeles Colon and Rectal Surgical Associates are board certified and well trained to diagnose and treat anal warts, as well as all other diseases of the colon, rectum and anus. While “An ounce of prevention is worth a pound of cure” a telephone call to Doctors Gary Hoffman, Eiman Firoozmand, Liza Capiendo, Stephen Yoo or Allen Kamrava may be the first step in getting help for an important and difficult problem. Education, prevention and treatment are all vitally important. (310)273-2310.
