Published on 06. February 2017

Problems with the "number two"?

The intestine and its excretions are still among the taboo subjects of our society. Hardly anyone likes to talk about "number two" and what it entails. But it is clear to everyone that what goes in at the top has to come out at the bottom. And this is not always without complications.

Dr. Skander Bouassida: "Relevant rectal disorders are often treated too late or badly. One reason: patients' sense of shame."

Every second adult is affected by a functional disorder or disease in the area of the rectum, more precisely in the colon, rectum or anus, in the course of his or her life. Not only older people, but also younger ones suffer from it and feel limited in their quality of life. It is important that diseases are treated at an early stage in order to exclude any consequential damage. This is often a problem in the case of diseases in the anal region, because many of those affected avoid visiting their family doctor or a specialist out of a sense of shame. The huge success of the book "Darm mit Charme" (Bowel with Charm) shows how much interest there actually is in the bowel and its tasks. In it, a young scientist introduces us to the "underestimated organ" as a biological marvel - and there is no need to feel self-conscious or embarrassed.

As head of the Clinic for Coloproctology at Vivantes Humboldt Hospital, head physician Dr. Skander Bouassida is familiar with patients' concerns and sensitivities.

Dr. Bouassida, how great are our inhibitions about talking about diseases around the bowel and anus?

For most people, a natural shyness makes it difficult to talk about problems and complaints around the anus. Yet anyone can be affected, no matter how old or whether they are men or women. Anal privacy and the processes that take place there are still among the taboos of our otherwise enlightened society. Already as a small child, one learns the ability to hold stool, i.e. continence, as well as bowel evacuation and intimate hygiene. After that, all this is taken for granted, and it is no longer talked about in normal everyday social life.

How do you experience patients in your everyday practice?

Impaired bowel or anus function is almost always associated with a high level of physical, psychological and social suffering. When patients come to our clinic, they have already taken a big step towards recovery.

What are the common symptoms?

Itching, burning, pain, skin wetting, excessive urge to defecate with the feeling of incomplete emptying, fecal incontinence. In inflammatory bowel disease, abdominal pain and diarrhea. Colorectal cancer (unfortunately) shows few early symptoms, such as bleeding or irregular constipation.

What examinations are necessary to make a correct diagnosis?

First of all, a palpation examination. In individual cases, a rectoscopy may also be necessary. Not all anus complaints, bleeding, lumps or pain are caused by hemorrhoids. Conversely, not all causes of discomfort require surgery. Often the causes are harmless and can be treated simply and easily. However, if a surgical intervention is necessary, we use a large number of gentle modern procedures in our clinic. In a consultation, we explain the individual measures to our patients in detail and answer their questions.

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