Generally, it is a bacterial infection which causes a build-up of pus in glands in the anal canal. Some inflammatory bowel disorders can result in anal abscesses forming more often.

A perianal abscess is diagnosed via rectal examination. Other tests may be recommended at the same time to detect other conditions that may be related, such as sexually transmitted diseases, inflammatory bowel conditions, diverticular disease or colon cancer.

Surgery is generally the most appropriate treatment for a perianal abscess. This involves surgical drainage, which drains the pus away. This procedure is performed under a general anaesthetic. Any pain related to the abscess goes away at this point, as it is the pressure of the pus in the abscess that causes the pain. In some cases, an anal fistula may also have formed, in which case further treatment may be required.

Some anal fissures heal of their own accord and do not need any medical treatment. However, a fissure may cause a spasm to develop in the anal sphincter muscle, which in turn reduces the normal flow of blood to the affected area. This can then prevent the fissure from healing normally. Usually dedicated medical therapy can be trialled in various forms to achieve complete resolution. If this therapy is not successful other interventions are possible. If this occurs, an anal fissure can be treated in two ways, BOTOX® Injection or Sphincterotomy.

This is the same active medication as is used in cosmetic surgery. One BOTOX® injection is applied to the anal sphincter. This non-surgical procedure has proved very successful for long term recovery. Complications are also minimised.

This procedure, known technically as a lateral internal sphincterotomy, is where a very small incision is made to the anal sphincter muscle (normally the lower section). This aids the natural healing process by restoring blood flow to the area around the fissure. A spincterotomy is only recommended when other treatments have not helped.

Medical science does not fully understand the exact cause, or causes of colorectal cancer, however it is linked to a number of diet and lifestyle factors which together increase the likelihood of any one individual developing the condition.
These risk factors for colorectal cancer include:

Sex
Women are marginally less likely to develop colorectal cancer than men.
Incidence in close relatives
This is a risk factor especially where one or more close family members have had colorectal cancer and/or where they have developed the condition at an early age.

Age
Colorectal cancer risk increases from the age of fifty.

Dietary Intake
A food intake high in meat and animal fat and low in fresh fruit and vegetables is a risk factor for the development of colorectal cancer.

Physical Activity
A low level of physical activity and/or a sedentary lifestyle is a risk factor for colorectal cancer.

Obesity
Being either obese or overweight is a risk factor.

Often colorectal cancer has no outward symptoms in its early stages. The following symptoms warrant further investigation in case they are caused by colorectal cancer:
• Change to bowel habits.
• Bleeding from the rectum / anus.
• Abdominal pain.
• Abdominal swelling.
• Fatigue / tiredness (this can be associated with bleeding in the bowel which in turn causes anaemia).
• Weight loss (where this is otherwise unexplained).
How is colorectal cancer diagnosed?
Colorectal cancer generally develops over a period of time, where a polyp becomes malignant. During a colonoscopy examination any polyps found are generally removed and sent for testing to determine if they are pre-cancerous or cancerous. Where colorectal cancer has developed, the primary treatment is surgery.

As described above, diverticular disease is in most cases asymptomatic, that is there are no symptoms. However, in some cases, a condition known as 'diverticulitis' can develop, which is where an infection can develop in the small indentations themselves and cause inflammation of the bowel wall. This in turn may cause the affected section of the bowel to constrict and result in either a change in bowel habits and/or bleeding from the rectum or anus.

Medical science is not entirely sure what causes diverticular disease. As it is more common in developed countries than elsewhere, it is believed to be associated with diet, especially a diet low in fibre (i.e. fruit/vegetables) and high in refined foods. A previous theory that it related to eating seeds and nuts is now considered unfounded.

Since it often has no symptoms, diagnosis of diverticular disease is often made during medical tests and examinations for other conditions. Where it is causing symptoms, a change in diet to include more fibre can often have beneficial results. There is no medication that treats the condition.

In severe cases of diverticulitis or where there are repeated occurrences, a blockage to the bowel or a perforation in the lining of the bowel may occur, in which case surgery will be needed.

With an anal fistula, an opening form on the skin which will often discharge blood and/or pus. A lump sometimes also appears on the skin. Some fistulas (or 'fistulae') have few symptoms and others can be painful or merely uncomfortable. These symptoms can also come and go.

A fistula can sometimes appear with no apparent cause, however fistulae are relatively common in cases of anal abscess and people with Crohn's Disease have an increased risk of developing one or more fistulae. Having said this most people who develop a fistula do not have any other bowel conditions.

A fistula, once formed, is very unlikely to heal itself without medical intervention. A surgical procedure is generally recommended to treat a fistula.

As the derivation of the word 'pilonidal' implies, the sinus - cavity - forms when hair on the lower back grows into and underneath the skin. Because this hair has been exposed to the air it may take bacteria with it under the skin and cause infection.

Any bacterial infection under the skin may cause:
• Pain.
• Swelling.
• Discharge of blood.
• Discharge of pus.

The condition primarily affects young adults (in their teens and twenties) and can affect men and women. Where this is an ongoing problem it is referred to as 'pilonidal disease'.

A pilonidal sinus can be treated without surgery, however where the condition recurs, or where the infection or the symptoms are severe, surgery is often recommended.