Anal Wart Treatments That Work

Did you know that treating anal warts early may help in avoiding anal cancer?

If you've discovered or think you might have anal warts, you should see a gastroenterologist to verify what you are experiencing. When left untreated, anal warts can lead to cancer in many men - especially if you have low or compromised immunity.

What are Anal Warts?

Anal warts (a type of genital warts) are warts around and inside the anus. According to The American Society of Colon and Rectum Surgeons, the size of anal warts can range from the size of a pinhead up to the entire rectal area. Anal warts come in three shapes: flat, cauliflower-shaped, or raised. Since they can be located inside the anus, you could have anal warts and not know.

What Causes Anal Warts?

Anal warts are caused by a Human Papillomavirus infection (HPV). HPV is a very common sexually transmitted disease that can resolve on its own, or cause anal warts to form, and can lead to cancer. Anal warts are part of a group of HPV warts, including warts on and around the anus, testicles, penis, groin, or thighs. You might have as few as one on or inside the anus, up to many located in various areas. 

HPV in Men

HPV in men manifests in a few different ways. HPV Symptoms in men often include HPV warts, but you could have HPV with no health-related problems or symptoms. This is a key factor in why it is so common, and why it spreads.

For many men, HPV can lead to penile or anal cancer. 800 men per year develop penile cancer due to HPV. And 1,100 men per year develop anal cancer due to HPV. 

The following signs and symptoms might indicate anal cancer, and should be communicated to your doctor:

• anal discharge, pain, itching, or bleeding.

• enlarged lymph nodes in the groin or anal area.

• stool-shape changes

• changes in bowel movements

Are Anal Warts Contagious?

Anal warts caused by Human Papilloma Virus can be sexually transmitted. The sexual experience that resulted in HPV for a man doesn't have to be recent, and you can get it even if you've only ever had one sexual partner. 

Other ways of spreading HPV and genital warts:

• contact from hand to the anal area

• body fluids from an infected person 

Is There an HPV Test for Men?

Since HPV is often undetected, patients can have the virus for years without knowing, passing it on from partner to partner. However, the virus often clears up on its own without causing health problems. 

"Over 20 million people in this country have HPV, and most do not know it."  

Unfortunately, there isn't a test for HPV in men. While there aren’t any approved tests for finding genital warts, you can often see them. 

Testing for HPV-Caused Health Problems

Since HPV is common and can disappear on its own, it's essential to focus on testing for the diseases that HPV can cause. For instance, there are anal pap tests that test for anal cancer. 

The best thing you can do if you think you have anal warts, HPV, or anal cancer is to make an appointment with a healthcare provider. 

HPV and Anal Wart Prevention

HPV vaccines (Gardasil) can prevent nine types of HPV - some that cause anal warts, and some that can cause cancer. It works best before the first sexual encounter, and it effectively prevents HPV, as long as you don't already have it. 

• The age group in which the vaccine is effective is 9-45

• It's effective for 90% of HPV types.

• It comes in a three-shot series over a six-month timespan 

There are other ways to prevent HPV, as well. The American Society of Colon and Rectal Surgeons recommends:

• avoid sexual contact with people who have genital warts

• have only one sex partner at any given time

• avoid sexual contact altogether

• have your sexual partners screened for STDs, including HPV - with or with symptoms

• condoms reduce the risk of contracting HPV, but they aren't fully effective 

HPV Treatment 

While there is no HPV treatment specifically, you can treat the problems HPV causes, like anal warts. It's essential to treat anal or genital warts as soon as you notice them because HPV can cause many types of cancer. According to the Centers for Disease Control and Prevention (CDC), when HPV causes cancer, the cancer can begin developing at any point and may do so slowly. 

What Types of Cancer Can HPV Cause in Men?

The types of cancer HPV can cause in men include:

• Penile cancer

• Anal cancer

• Oropharyngeal cancer (located where the tongue and tonsils meet)  

Some men develop HPV-related cancers more easily than others. Men who possess a weak or compromised immune system (with or without HIV) are more likely to develop HPV-related cancers. According to the CDC, men receiving anal sex are not only more likely to develop HPV-related cancers, but they’re also more likely to suffer from anal cancer. 

Anal Wart Treatments

Anal warts must be removed, or they might grow, or you might develop several more anal warts. Anal wart treatments come in two types: surgical or non-surgical. Unfortunately, warts located inside the anus might not disappear with a topical medication, meaning surgery might be necessary. 

Non-Surgical Treatments for Anal Warts

• HPV anal cream works best if the warts are tiny or are only located on the skin 

• Liquid nitrogen may be utilized by your doctor to completely freeze and thereby destroy anal warts

• Trichloroacetic acid or Podophyllin may be used by your doctor to burn off warts in a safe manner 

Surgical Treatment for Anal Warts

In cases of large warts or internal anal warts, surgery is the best option. After an internal exam to look for inside lesions, your doctor will let you know if they will surgically remove your warts and schedule your surgery. Then, your gastroenterologist performs the surgery following anesthesia. Lastly, your physician may schedule multiple surgeries if there are multiple warts.

If you're suffering from anal warts, don't wait.

Dr. Dale Prokupek's patients highly recommend him, and he received the Patient's Choice Award. A gastroenterologist and an associate clinical professor of medicine at the Geffen School of Medicine at UCLA, Dr. Prokupek takes his appointments in his private practice, located in Beverly Hills and the Cedars-Sinai Medical Center. 

Click here to schedule an appointment. 

How Often Should I Get a Colonoscopy?

A colonoscopy is the most effective way to screen for colon cancer. Colonoscopies are a routine procedure you don’t want to overlook or ignore – but how often should I get a colonoscopy, and at what age do you get a colonoscopy for the first time? 

Here’s what you need to know about getting colonoscopies, when to get a colonoscopy, how often, and even how to correctly prepare for one. 

At What Age Do I Need to Get a Colonoscopy?

As your age increases, so does your risk for polyps and colon cancer. Regardless of your gender or how healthy you are, it’s recommended that you begin getting colonoscopies by the age of 45, and in most cases you should get a colonoscopy at least once every ten years. There are also reasons to get colonoscopies more frequently.

The 10-year rule only applies if you’re not already at risk for bowel conditions. You may need to begin getting colonoscopies earlier than age 45 (and at least once a year) if you have a family history of colon or bowel cancer or have already been diagnosed with a bowel condition, such as: 

• Colorectal polyps

• Irritable bowel syndrome (IBS)

• Inflammatory bowel disease (IBD) 

For conditions like Crohn’s Disease or ulcerative colitis, you’ll need to consult with your doctor about the exact frequency you should be getting colonoscopies  – and at what age they should begin. 

When Is it Recommended to Get a Colonoscopy if You Have a History of Bowel Cancer? 

If you already have a history of colon cancer in your family, it’s never too early to schedule your first colonoscopy.  However, if you want to avoid colonoscopies until you absolutely need to, the American Cancer Society doesn’t begin recommending regular colonoscopies until the age of 45 for anyone with an average risk of cancer. There are however earlier age recommendations and reasons to take a more proactive approach. 

Anyone that’s already dealt with a colon cancer diagnosis or has a high risk of it in their family may need to start at the age of 40. In some cases, doctors have even recommended for people to get their first colonoscopy at 35 if they had a parent diagnosed with colon cancer. 

Keep in mind that, regardless of how often your doctor might suggest scheduling colonoscopies, some insurance companies still limit how often they’ll cover your screenings (if you don’t have a cancer diagnosis). Depending on the policy, if you start your screenings at 35, you may not be able to get your insurance company to cover another colonoscopy until you’re 40 or 45  – but it depends on your specific risk and what you’ve been diagnosed with. 

What Happens During a Colonoscopy? 

For anyone that’s never had a colonoscopy before, but their first procedure is approaching, wondering about it can make one anxious, so it’s important and frankly comforting to know exactly what will be happening. 

The actual colonoscopy procedure is performed by a doctor, often in an exam room, and takes about 30 to 60 minutes. You’ll be given medication that completely relaxes your body, and your doctor will ask for you to lie on your left side on an exam table. 

A colonoscopy is not surgery. Throughout a colonoscopy procedure, the doctor will use a flexible, long instrument with a camera called a colonoscope, to look for any abnormalities in your colon. Not only does the scope provide a clear picture of your colon, but a colonoscopy can also blow air into your colon for a clearer image as well. 

For many people, colonoscopies can be uncomfortable and cause a little cramping while they’re happening, but this should go away once the colonoscope has been removed from your rectum. 

If your doctor spots anything that looks out of the ordinary, they may take out small amounts of tissue to analyze or remove abnormal growths and polyps. 

As uncomfortable as a colonoscopy may sound, the routine procedure is a lot more convenient (and less painful) than undergoing an intrusive operation. This is why colonoscopies are frequently recommended as a preventative care technique; catching cancers early is the best way to beat them and the lesser of two evils, for certain.

How Do I Prepare for a Colonoscopy? 

In order for doctors to get a clear and accurate picture of your colon, you’ll need to prepare for the procedure beforehand. 

When your colonoscopy gets scheduled, your doctor should provide instructions about how to prep for the procedure. For a successful colonoscopy, you’ll need to attend your appointment with a completely emptied-out colon. 

Three to four days leading up to your colonoscopy, you’ll start a colonoscopy prep diet, detailed in the next section. 

Part of preparing for a colonoscopy procedure will require that some personal time be set aside the night before your colonoscopy, when you’ll be taking a strong laxative, aka your colonoscopy prep drink. Be aware that it will be rather forceful and uncomfortable, so you’ll want to stay home and in the bathroom until it’s over. It’s usually recommended that you clear your schedule the night before the colonoscopy, and make arrangements for someone to drop you off and pick you up from the procedure. 

What is a Colonoscopy Prep Diet? 

Colonoscopies require that you cleanse your colon – this means tweaking your diet for the days leading up to the procedure. Your doctor may ask that you eat light meals for a couple of days before, and that you stick with low-fiber foods that are easy to digest, including: 

• Rice, pasta, and white bread

• Eggs

• Well-cooked vegetables that don’t have the skin on them 

• Fruits that don’t contain the seeds or skin 

• Lean meats such as fish or chicken 

Your doctor will also usually direct you to avoid high-fiber or hard-to-digest foods like these: 

• Tough meat, including red meat

• Nuts, popcorn, and seeds 

• Vegetables like corn, broccoli, peas, beans, and cabbage

• Fruits that include seeds or skins that you can’t remove

• Fatty foods 

• Whole grains 

On the day before your colonoscopy procedure, it’s standard for you not to be able to eat anything solid, and only to have clear liquids. Clear juices are usually fine, and as long as you don’t add any cream to it, you should be able to have your coffee or tea. 

To clean out your colon, you’ll also be given a colonoscopy prep drink that’ll help ensure your bowels are clear by the time of the procedure. This is the part of the entire process that may take the most time out of your schedule, so be mindful to plan to be home.

For more information about preparing for a colonoscopy or colonoscopy prep options, see How Do I Prepare for a Colonoscopy? 

Don’t Wait to Book Your Colonoscopy Appointment

Whether you’re approaching the age where you need a colonoscopy or you’re worried about an increased risk of colon conditions, don’t wait to book your colonoscopy or to consult a doctor. Everyone, regardless of how healthy they may be, needs a routine colonoscopy. Contact me today to schedule an appointment or learn more about when you’ll need a colonoscopy. 

Your Guide to Relieving the Discomfort of Hemorrhoids

Some estimates suggest around three quarters of Americans will experience hemorrhoids. Many hemorrhoids will disappear in several weeks on their own. Some are more stubborn and can make life very uncomfortable.

Fortunately, there’s a lot you can do to relieve the pain these swollen veins in your anus and lower rectum can cause. Read on to find out about treatment options for relieving hemorrhoids.

What Causes Hemorrhoids?

The veins around your anus have a tendency to elongate under pressure. They may then swell and expand. Hemorrhoids can happen as a result of an increase in pressure in the lower rectum. Common reasons for what causes hemorrhoids are these:

• Straining when you’re having a bowel movement

• Spending extended periods sitting on the toilet

• Experiencing severe diarrhea or chronic constipation

• Obesity

• Going through pregnancy

• Having a diet that is low in fiber 

• Heavy lifting as part of work or exercise

External Hemorrhoids and Internal Hemorrhoids Explained

Hemorrhoids, often referred to as piles, are a little bit like varicose veins. How hemorrhoids can make you feel and how to treat them is to some extent dependent on their type, internal or external.

External Hemorrhoids

External hemorrhoids develop under the skin around your anus. These may become bleeding hemorrhoids. Here are some of the things that can happen:

• Itchiness or soreness in the area near the anus

• Pain and irritation

• A swelling or series of swellings close to the anus

Internal Hemorrhoids

Internal hemorrhoids develop inside the rectum itself. You normally would not be able to see or feel them, and they don’t usually cause discomfort. However, straining or irritation when passing a stool can lead to:

• A painless loss of blood when you have a bowel movement

• A hemorrhoid pushing through the anal opening resulting in pain 

If blood pools in an external hemorrhoid and goes on to create a clot, this can lead to severe pain and a hard lump next to your anus. 

Bleeding Hemorrhoid Treatments to Relieve Pain and Irritation

You might only experience mild pain, swelling, and inflammation from your bleeding hemorrhoids. Treatment can be effective in a few simple steps: 

Eating High-Fiber Foods 

If you consume more fruits, vegetables, and whole grains you will soften your stool. This can help reduce the kind of straining that can make the symptoms of hemorrhoids worse.

Preparation H, Hemorrhoid Cream, and Topical Treatments

You can apply popular products such as Preparation H for immediate relief. You might also try a hemorrhoid cream bought over the counter or a suppository that contains hydrocortisone. Witch Hazel pads or a numbing agent can help too. 

You should avoid using over-the-counter steroid creams for more than 7 days unless your doctor has advised you to do so.

Soaking in a Warm Bath or Sitz Bath

Bathing your anal region in plain warm water for around 10 to 15 minutes a few times a day can bring relief from itching. Sitz baths will fit on top of your toilet. 

You can combine these home remedies with oral pain relievers such as aspirin or ibuprofen.

How Do I Get Rid of Hemorrhoids?

Sometimes a painful blood clot or thrombosis forms within an external hemorrhoid. In these cases, your doctor will know how to get rid of hemorrhoids. Removing them brings almost immediate relief. 

Your doctor will carry out this procedure under local anesthesia. For best results, you should undergo an external hemorrhoid thrombectomy within three days of the clot developing. 

Minimally Invasive Procedures

Sometimes hemorrhoids can cause continual bleeding and constant pain. In these circumstances, your doctor might suggest another minimally invasive procedure. 

These kinds of treatments can take place at your doctor's office or another outpatient facility. They don’t normally need anesthesia. Here are some of the options available. 

Rubber Band Ligation

Your doctor will attach one or two small rubber bands around the bottom of an internal hemorrhoid. This restricts blood circulation. The hemorrhoid shrinks and will drop off within 7 days or so. 

You might experience a little discomfort and, although bleeding might occur up to 4 days after the procedure, it’s rarely serious. 

Sclerotherapy

During a sclerotherapy procedure for hemorrhoids, your doctor will inject a chemical solution into the hemorrhoid tissue. This will shrink it. The injection will typically cause little or no pain. It sometimes has less effect compared with rubber band ligation. 

Coagulation 

A coagulation procedure uses laser, infrared light, or heat to relieve hemorrhoids. The treatment will make small, bleeding, internal hemorrhoids harden and then wither. There are typically no side effects or discomfort with this procedure.

Surgical Procedures

Only a small fraction of those with hemorrhoids will need to undergo surgery. Sometimes surgery is used after other procedures are not successful. You may also have particularly large hemorrhoids. In these cases, your doctor might recommend one of these treatments.

Hemorrhoidectomy Hemorrhoid Removal

Your doctor will select from a variety of techniques to address more serious hemorrhoids and take away any excess tissue which causes bleeding. The medical team will carry out this kind of surgery with local anesthesia. They’ll combine this with sedation, spinal anesthesia, or general anesthesia.

Hemorrhoidectomy is the best and most thorough way to treat the most serious hemorrhoids and those which keep coming back. You might experience some pain after the procedure which prescribed medications will relieve. 

Hemorrhoid Stapling

Doctors refer to this procedure as a stapled hemorrhoidopexy. The treatment will stop the blood flow to the hemorrhoidal tissue. Doctors usually only carry this procedure out to treat internal hemorrhoids.

Stapling typically causes less pain than hemorrhoidectomy. Patients will get back to regular activities more quickly. However, this procedure might cause greater long-term risks. These can include an increased chance of hemorrhoid recurrence or rectal prolapse.

Seek Medical Help Now

You may have already tried treating your hemorrhoids at home. You might also be looking for a longer-term solution. The best place to start is by visiting your doctor. They will be able to advise you of the best course of action. 

If you’re in Los Angeles, click below to schedule an appointment with me.