Keeping it Clean: Should I Use Soap on My Anus?

Soap? No Soap!! Get the PDF version of this article Soap may be an important part of one’s bathing routine, but do I need to wash my anus?  The short answer is no. The longer answer is also no!  To elaborate, would you clean your eye with soap?  The anus, although the butt of many

How Are Hemorrhoids Graded?

Hemorrhoids are more common than most people realize. One study found that approximately 10 million people in the United States are suffering from hemorrhoids at any given time.  Since most people are hesitant to talk to their doctors about their symptoms and first try over-the-counter treatments, the actual numbers could be much higher.   Why


Get the PDF version of this article YUCH!!!! “Doc, I can’t sleep because I’m scratching my bottom all night! I swear, I either have pinworms or I’m crazy!”Such is a common complaint in the colorectal surgeon’s office, from a patient sitting uncomfortably and sideways.While there are many causes of anal itching (pruritus ani), patients and

Medical Treatment for Anal Fissures

There Is A First Time For Everything. An anal fissure is one of life’s more painful conditions.  Often, excruciatingly painful.  And, for patients experiencing the fissure for the first time (yes, it can recur over and over again), the pain is made worse by lack of knowledge as to how to treat the fissure, and

12 Reasons to Schedule a Visits to the Proctologist

A Proctologist?  At My Age? As we age, issues that never would have drawn a second thought, seem to become front and center in our thinking and in our daily habits.  Things like sore feet, difficulty seeing objects close up or far away and thinning hair readily come to mind.  But, who would have ever

Anal Soap Equals Anal Pain & Itching

Soap? No Soap! A famous British proctologist, when referring to anal hygiene, once remarked that “People do more harm to their anal opening by trying to polish it clean, than if they would have simply left it alone.” And therein is the rub (so to speak). Colon and rectal surgeons have long known that with

Can Hemorrhoids Burst?

Hemorrhoidal tissue is a normal part of everyone’s anatomy; everyone has these veins. In some people, though, they become enlarged. This leads to pain, irritation and sometimes bleeding. Reports indicate that about 40 percent of adults in the United States suffer from this condition. Many people fear not only the pain and itching associated with

Hemorrhoids and Tailbone Pain. A Real Pain in the…

Rarely can a problem such as hemorrhoids cause so many different symptoms. Everyone has heard that hemorrhoids can bleed, may protrude and can cause itching. But what about tailbone pain? Tailbone pain is that sharp or dull discomfort that you might feel during prolonged sitting, walking or even while sleeping. In fact, tailbone pain is

Anal Fissures and Stress: How Are They Related

Why Do I Hurt?  What Is An Anal Fissure? “I have pain.”  “My rear end hurts!”  “It’s killing me!!!”   These are common complaints heard by every proctologist (also known as a colon and rectal surgeon or coloproctologist), every day in big cities. Big cities, stress and anal fissures.  Los Angeles.  Fissures.  All day, all week.

Tem. Tamis. Same Local Excision, Different Acronyms.

Get the PDF version of this article. Alphabet Soup What is TEM? What is TAMIS? Transanal Endoscopic Microsurgery (TEM), or Transanal Minimally Invasive Surgery (TAMIS) are two acronyms for the same operative procedure, in which a rectal mass or lesion is removed using a minimally invasive approach through the anal opening.   TEM was developed to

Ruptured Hemorrhoid Symptoms

Blood In Your Stool.   Hemorrhoids? Noticing blood in your stool can be a frightening experience.  If this is the first time that you have seen the blood, the feelings and thoughts can go beyond frightening.  However, a quick trip to the proctologist, also known as a colon and rectal surgeon, is usually reassuring. There’s Blood

Cedars-Sinai Proctologists

Los Angeles Colon and Rectal Surgical Associates No one wants to hear the news…you have cancer. But many people will develop colorectal cancer.   Even more people will face benign problems that affect the colon and rectum. But with the right treatment from the experienced physicians and surgeons of Los Angeles Colon Rectal Surgical Associates,

New Laser Treatment for Rectal Fistulas

The Anorectal Fistula.  What Is It? The anal area is a complex anatomical location.  The anal canal is designed to store stool until such time as it can be discharged.  As such, the anus is endowed with nerves (to sense the arrival of stool) and muscles (to hold the stool and then help to discharge

Excercising With Hemorrhoids: The Do’s & Don’ts

Hemorrhoids and Exercising Exercising with hemorrhoids? You might find the whole idea to sound like a catch-22. On the one hand, exercise can seem to worsen any symptoms that you might have, related to hemorrhoids. Strenuous activities and heavy lifting can cause hemorrhoids to swell, exacerbating the symptoms. On the other hand, a lack of

What is a Colon and Rectal Surgeon

Becoming A Surgeon.  Extensive Training A colon and rectal surgeon is a physician with a university degree and a medical degree (M.D.).  Medical school is a four year education during which time the medical student studies all aspects of the human body and then participates in caring for patients.  Following graduation from medical school, the

How Common is Condyloma Acuminata, Anal Warts

Anal Warts.  A Visit To The Proctologist. By now, most people have heard of the term anal warts, also known as condyloma acuminata.  Anal warts are common and are transmissible.  Whether transmitted sexually (STD’s), or in other, non-sexual transmission modes, these small, fleshy lumps are a source of irritation at a minimum, and a possible

Female Proctologist in LA – Liza M. Capiendo, M.D.

Why A Female Proctologist? Are you looking for a female proctologist in Los Angeles? As always, choosing the proctologist with whom you are comfortable and who suits your needs is an important decision. But if you’re a woman, it may be especially important to find a female proctologist. Some female patients prefer to have a

Proctologist or Gastroenterologist. Is There A Difference?

Did You Hear This One? What are the real differences between a colon and rectal surgeon,  also known as a proctologist, and a gastroenterologist? There is an old joke known in medical circles.  It goes something like this:  What is the difference between an internist, a surgeon and a pathologist (a doctor who examines tissue

How to Identify Hemorrhoids, Internal & External

About 75 percent of Americans will develop hemorrhoids at some point in their lives, yet many people may not know that there are two varieties of this common problem. Though external and internal hemorrhoids are caused by the same factors, their symptoms can be very different—knowing the signs of each can help you stay free of them and seek treatment for hemorrhoids in Los Angeles as soon as you need it.

THD: A New Approach?

A relatively new, tested and improving technology is making steady gains in the realm of operative interventions. It is transanal hemorrhoidal dearterialization (THD). It is considered to be a part of the “minimally invasive” family of surgical interventions.

Tips to Avoid Anal Fissures

Anal fissures are the third most common condition of the rectum, but they don’t have to be. Taking measures to prevent the most common causes of anal fissure such as constipation and diarrhea by improving digestion and encouraging healthier bowels can also reduce your likelihood of developing anal fissures, and there are several ways that you can go about this.

Anal Pain

Get the PDF version of this article BEWARE: IT’S NOT ALWAYS JUST HEMORRHOIDS… Anal Pain is common, and commonly misdiagnosed. Most patients and many clinicians assume that a complaint of anal pain is synonymous with a diagnosis of hemorrhoids, especially when the pain is associated with the presence of bright red blood. A familiarity with

Colorectal Surgeon vs. Gastroenterologist

Many patients often do not know if they need to see a Colon and Rectal Surgeon or a Gastroenterologist for their symptoms or condition. Moreover, even more are confused as to the difference between a Colon and Rectal Surgeon and a Gastroenterologist. The differences between the two specialties can be quite large. Because we treat

Rectal Foreign Bodies

Get the PDF version of this article HOW TO REMOVE A RECTAL FOREIGN BODY IN ONE EASY STEP (RARE IS THE PATIENT WHO EXPERIENCES THIS PROBLEM TWICE) THE END For those with a short attention span and a desire for immediate answers, here is the conclusion of this article: CONCLUSION: From a safety standpoint, the

Anal Cancer – Part 4. Unusual Anal Cancers.

Squamous cell cancer of the anal canal is rare and adenocarcinoma is rarer still, accounting for 10% of all anal cancers. , The three types of anal adenocarcinoma are those arising in the anorectum, those arising in anal glands, and those arising in an anorectal fistula.

Anal Cancer – Part 1. Malignant Precursors.

Anal neoplasms are a rare, diverse group of lesions. Each manifests a different behavior. With the recent publicity surrounding anal cancer, attention has focused on screening, early diagnosis and treatment.

PPH: To Staple or Not to Staple: That is the Question

Get the PDF version of this article INTRODUCTION Symptomatic internal and external hemorrhoids present with some of the most vexing problems known to mankind and to surgeons. Each year, over 525,000 patients are treated for symptoms associated with hemorrhoids. (1) Of these, 10-20% ultimately require surgical treatment. Watch this brief video of Hemorrhoid Treatment Options

Anal Cancer – Rare Malignant Tumors of The Anus

Get the PDF version of this article The Good News? These are Rare Lesions. PERIANAL TUMORS: “Most of these rare anal tumors are aggressive tumors and are difficult to treat. The best that can be said of them is that they are rare.” pdf only Paget’s Disease Perianal Paget’s disease is thought to be a

Procedure for Prolapse & Hemorrhoids (PPH)

A 15- to 35- minute minimally invasive procedure is the new gold standard for hemorrhoidectomy, according to American and European experts in the field. The procedure, known as PPH (procedure for prolapse and hemorrhoids) stapled hemorrhoidectomy, combines hemorrhoidal devascularization and repositioning to return the veins to the anal canal. “This year, this is the revolutionary new procedure in the United States,” Gary Hoffman, MD, clinical faculty member in general and colorectal surgery, Cedars-Sinai Medical Center, Los Angeles, told General Surgery News after moderating a live PPH telesurgery at the 2003 annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons. “PPH stapled hemorrhoidectomy will supplant the traditional open operations in patients with symptomatic grades 3 and 4 hemorrhoids, because it results in a tremendous reduction in postoperative pain, and in a rapid return to work and to activities of daily living.”

Anal Abscess & Perirectal Fistula

With the development of a new material and a relatively painless technique to close a perianal or perirectal fistula, it is useful to review the pathophysiology and treatment options for anal abscesses and anorectal fistulae. The new material, Surgisis®, is composed of po­­­rcine small intestinal submucosa ­rolled into a conical shape and inserted into an existing fistula (figure 1). This allows for tissue ingrowth and fistula closure.


Flatus, or gas is an expected and natural by-product of the normal functioning of the gastrointestinal tract. On average, between one half to two liters of gas are produced daily. This gas is eliminated through the anus approximately fourteen times per day.

The formation and elimination of flatus while normal, may be both uncomfortable and embarrassing and may be the source of laughter, concern or curiosity.

Hemorrhoids – Small Size, Big Problems

Hemorrhoidal disease is a considerable source of morbidity, affecting twenty million adults per year. Symptoms can be debilitating and costly when measured in time away from productive activities. In 1980, during game two of the World Series between the Kansas City Royals and the Philadelphia Phillies, George Brett was forced to leave the game in the sixth inning due to hemorrhoidal symptoms. After a minor surgical procedure, he returned for game three and hit a first inning home run blast in the Royals 4 to 3 win. He quipped “…my problems are all behind me…” The Royals lost the series and Brett underwent a hemorrhoidectomy in the off season.

Anal Rash | Pruritus Ani – For Physicians

Anal itching. Pruritus ani. At one time or another, everyone has experienced this unpleasant sensation. Most often, the delightful scratching of the itch relieves the discomfort and puts a stop to the maddening sensation. Not uncommonly however, the itch occurs at an inconvenient moment, in public, during an intimate social situation or at a time when scratching is not possible without looking a bit ridiculous. Worse, the itching may become chronic, with the need to scratch becoming a constant annoyance, bordering on pain.

Anal Fissure

Anal fissures are a common problem, bringing many patients to the colorectal surgeons’ office with complaints of anal pain. Most patients report feeling a tear, or a splitting sensation at the anus after a normal bowel movement, a bout of diarrhea, or after a particularly hard or large stool.

Anal Cancer – Squamous Cell Carcinoma

Squamous cell carcinoma of the anus is the most well known member of an uncommon group of GI neoplasms. The incidence of this tumor has been increasing slowly, with 3,500 cases reported in the United States in 2001, and 5,260 cases reported in 2009.