- Warts
- Arthritis
- Medical Weight LossThe most common symptoms are rectal bleeding and changes in bowel habits, such as constipation or diarrhea. (These symptoms are also common in other diseases so it is important you receive a thorough examination should you experience them.) Abdominal pain and weight loss are usually late symptoms indicating possible extensive disease.
- Primary CareThe simpler tests such as digital rectal examination, fecal occult blood testing, or flexible sigmoidoscopy may be performed by your primary care physician or your surgeon. They can also arrange for colonoscopy to be performed by a specially trained physician, such as a colon and rectal surgeon.
- Smoking CessationFew cancers can be totally prevented, but the risk of developing anal cancer may be decreased significantly by avoiding the risk factors listed above and by getting regular checkups. Avoiding anal sex and infection with HPV and HIV can reduce the risk of developing anal cancer. Using condoms whenever having any kind of intercourse may reduce, but not eliminate, the risk of HPV infection. Smoking cessation lowers the risk of many types of cancer, including anal cancer. Vaccines against infection with certain types of HPV, especially in high-risk patients (see risk factors listed above), may also decrease the risk of developing anal cancer (in men and women).
- Emergency CareYou can expect to have pain following hemorrhoid surgery. The goal is to make it manageable, but it may be up to 2-4 weeks before you’re able to resume your full level of activities. You likely will be given a variety of medications that have been specifically chosen for their ability to work together and address your pain in different ways. Sitting in a bath (sitz bath) 2–3 times daily for 10-15 minutes per time in warm water up to your lower abdomen may make you more comfortable. Occasionally, patients will have difficulty urinating after anorectal surgery. If you are unable to void, try urinating in the tub during a sitz bath. If that does not work, proceed to an emergency department for placement of a catheter in your bladder. Failure to do so can result in permanent bladder damage from over-stretching.
- ColonoscopyWhen a polyp or cancer is detected by flexible sigmoidoscopy, or if a person is at high risk to develop colon and rectal cancer, colonoscopy provides a safe, effective means of visually examining the full lining of the colon and rectum. Colonoscopy is used to diagnose colon and rectal problems and to perform biopsies and remove colon polyps. Most colonoscopies are done on an outpatient basis with minimal inconvenience and discomfort.
- Constipation
- Urinary IncontinenceSeveral factors may contribute to the development of rectal prolapse. It may come from a lifelong habit of straining to have bowel movements or as a late consequence of the childbirth process. Rarely, there may be a genetic predisposition. It seems to be a part of the aging process in many patients who experience stretching of the ligaments that support the rectum inside the pelvis as well as weakening of the anal sphincter muscle. Sometimes rectal prolapse results from generalized pelvic floor dysfunction, in association with urinary incontinence and pelvic organ prolapse as well. Neurological problems, such as spinal cord transection or spinal cord disease, can also lead to prolapse. In most cases, however, no single cause is identified.
- DiarrheaFor most people, having a bowel movement is a seemingly automatic function. For some individuals, the process of evacuating stool may be difficult. Symptoms of pelvic floor dysfunction include constipation and the sensation of incomplete emptying of the rectum when having a bowel movement. Incomplete emptying may result in the individual feeling the need to attempt a bowel movement several times within a short period of time. Residual stool left in the rectum may slowly seep out of the rectum leading to reports of bowel incontinence.
- Pregnancy
- Labor and DeliveryThere are many causes of incontinence. Injury during childbirth is one of the most common causes. These injuries may cause a tear in the anal muscles. The nerves supplying the anal muscles may also be injured. While some injuries may be recognized immediately following childbirth, many others may go unnoticed and not become a problem until later in life. In these ¬situations, a prior childbirth may not be recognized as the cause of incontinence.
- Ovarian CancerColorectal cancer is the second most common cancer in the United States. The average person's lifetime risk of developing it is about one chance in 20. The risk is increased if there is a family history of colorectal polyps or cancer, and is still higher if there is a personal history of breast, uterine or ovarian cancer. Risk is also higher for people with a history of extensive inflammatory bowel disease, such as ulcerative or Crohn's colitis.
- Cervical CancerPelvic radiation - People who have had pelvic radiation therapy for rectal, prostate, bladder or cervical cancer are at increased risk.
- Colon CancerThere are several methods for detection of colorectal cancer. These include digital rectal examination, a chemical test of the stool for blood, flexible sigmoidoscopy and colonoscopy (lighted tubular instruments used to inspect the lower bowel) and barium enema. Be sure to discuss these options with your surgeon to determine which procedure is best for you. Individuals who have a first-degree relative (parent or sibling) with colon cancer or polyps should start their colon cancer screening at the age of 40.
- Multiple SclerosisMore serious causes of constipation include growths or areas of narrowing in the colon, so it is wise to seek the advice of a colon and rectal surgeon when constipation persists. Individuals with spinal cord injuries frequently experience problems with constipation. Constipation may be a symptom of diabetes. Constipation may also be associated with scleroderma, or disorders of the nervous or endocrine systems, including thyroid disease, multiple sclerosis, or Parkinson's disease.
- Diabetes Care
- Thyroid
- UltrasoundA physical exam of the anal region should be performed. It may readily identify an obvious injury to the anal muscles. In addition, an ultrasound probe can be used within the anal area to provide a picture of the muscles and show areas in which the anal muscles have been injured.
- MRIFollow-up care to assess the results of treatment and to check for recurrence is very important. Most anal cancers are cured with combination therapy and/or surgery, so you should report any symptoms or problems to your doctor or surgeon right away. In addition, many tumors that recur may be successfully treated with surgery if they are caught early. A careful examination by an experienced physician or colon and rectal surgeon at regular intervals is the most important method of follow-up. Additional studies, such as certain types of scans (for example, CT or MRI) or ultrasounds, may also be recommended.
- X-Rays
- Computed TomographyAnal cancer is usually found on examination of the anal canal because of the presence of symptoms listed above, on routine yearly physical exams by a physician (rectal exam for prostate check or at the time of a pelvic exam), or on screening tests such as those recommended for preventing or diagnosing colorectal cancer (for example: colonoscopy or lighted scope exam of the colon and rectum or yearly stool blood tests). Anoscopy, or examination of the anal canal with a small, lighted scope, may be performed as well to assess any abnormal findings. If an abnormal area in the anal canal is identified based on the doctor’s exam, a biopsy will be performed to determine the diagnosis. If the diagnosis of anal cancer is confirmed, additional tests to determine the extent of the cancer may be recommended, which may include ultrasounds, Xrays, CT scans, and/or PET scans.
- ChemotherapyColorectal cancer requires surgery in nearly all cases for complete cure. Radiation and chemotherapy are sometimes used in addition to surgery. Between 80-90% are restored to normal health if the cancer is detected and treated in the earliest stages. The cure rate drops to 50% or less when diagnosed in the later stages. Thanks to modern technology, less than 5% of all colorectal cancer patients require a colostomy, the surgical construction of an artificial excretory opening from the colon.
- Radiation TherapyCombination therapy including radiation therapy and chemotherapy is now considered the standard treatment for most anal cancers. Occasionally, a very small or early tumor may be removed surgically (local excision) without the need for further treatment and with minimal damage to the anal sphincter muscles that are important for bowel control. On occasion, more major surgery to remove the anal cancer is needed, and this requires the creation of a colostomy where the bowel is brought out to the skin on the belly wall where a bag is attached to collect the fecal matter.
- General SurgeryDr. Wallet is certified by the American Board of Surgery  and the American Board of Colon and Rectal Surgery  and is a fellow of the American College of Surgeons  and the American Society of Colon and Rectal Surgeons. He received his undergraduate degree from Brandeis University, and his medical degree from Jefferson Medical College. He trained in general surgery at York Hospital in York, PA, and in colon and rectal surgery at Thomas Jefferson University Hospital in Philadelphia, PA. Dr. Wallet has been practicing colon and rectal surgery in Fort Wayne since 2012.
- Robotic SurgeryDr. Wallet has a special interest in minimally invasive treatment of colon and rectal diseases as well as treatment of pelvic floor disorders. He is the first surgeon in northeast Indiana to perform InterStim for fecal incontinence. His training and practice cover the entire field of colon and rectal surgery, including cancers, diverticular diseases, inflammatory bowel diseases, benign anorectal conditions, functional colon disorders and disorders of the pelvic floor and anal sphincters. He is certified in daVinci Robotic Surgery, Solesta  treatment for fecal incontinence, and InterStim sacral nerve stimulator for fecal incontinence.
- HysterectomyThere are many things that can lead to weakening of the pelvic floor, resulting in a rectocele. These factors include: vaginal deliveries, birthing trauma during vaginal delivery (e.g. forceps delivery, vacuum delivery, tearing with a vaginal delivery, episiotomy during vaginal delivery), history of constipation, history of straining with bowel movements, and history of gynecological (hysterectomy) or rectal surgeries.
- BotoxSurgical options for treating anal fissure include Botulinum toxin (Botox®) injection into the anal sphincter and surgical division of a portion of the internal anal sphincter (lateral internal sphincterotomy). Both of these are performed typically as outpatient, same-day procedures, or occasionally in the office setting. The goal of these surgical options is to promote relaxation of the anal sphincter, thereby decreasing anal pain and spasm, allowing the fissure to heal. Botox® injection results in healing in 50-80% of patients, while sphincterotomy is reported to be over 90% successful. If a sentinel pile is present, it may be removed to promote healing of the fissure. All surgical procedures carry some risk, and a sphincterotomy can rarely interfere with one’s ability to control gas and stool. Your colon and rectal surgeon will discuss these risks with you to determine the appropriate treatment for your particular situation.
- LesionsCrohn's disease can affect any part of the intestine, symptoms may vary greatly from patient to patient. Common symptoms include cramping, abdominal pain, diarrhea, fever, weight loss, and bloating. Not all patients experience all of these symptoms, and some may experience none of them. Other symptoms may include anal pain or drainage, skin lesions, rectal abscess, fissure, and joint pain (arthritis).
- Physical TherapyPelvic floor dysfunction due to non-relaxation of the pelvic floor muscles may be treated with specialized physical therapy known as biofeedback. With biofeedback, a therapist helps to improve a person’s rectal sensation and pelvic floor muscle coordination. There are various effective techniques used in biofeedback. Some therapists train patients by teaching them to expel a small balloon placed in the rectum. Another technique uses a small probe placed in the rectum or vagina or electrodes placed on the surface of the skin around the opening to the rectum (anus) and on the abdominal wall. These instruments detect when a muscle is contracting or relaxing and provide visual feedback of the muscle action. This visual feedback helps the individual to understand the muscle movement and aids in improving muscle coordination. Approximately 75% of individuals with pelvic floor dysfunction experience significant improvement with biofeedback.