Foreword
Acknowledgements
Out of the Shadows
The Beginning and the End
When You See a Colorectal Surgeon
The Physical Examination
The Discussion
The Consent Process
1 "I See Blood" - Hemorrhoids
What Is a Hemorrhoid?
Symptoms and Assessment
Grading Hemorrhoids
Mixed Hemorrhoids
Colonoscopy? Required for Hemorrhoids?
How Are Hemorrhoids Treated?
Conservative Management
Rubber Band Ligation (RBL)
Hemorrhoidectomy
It's Just Hemorrhoids? Not Cancer?
Polyps
Diverticulosis
2 "My Bum Hurts" - Fissure, Thrombosed External Hemorrhoid, Abscess
Fissure
How Are Fissures Treated?
Acute Fissures
Chronic Fissures
Thrombosed External Hemorrhoid
Abscess
Anal Pain Postscript
3 "This Itch Is Driving Me Crazy" - Pruritus Ani
Primary Pruritus Ani
Two Contributory Theories
The Treatment? A Discussion
Secondary Pruritus Ani
4 "I Have a Bump on My Butt that Won't Go Away" - Fistula
What Is a Fistula?
How Are Fistulas Treated?
Fistulotomy
Determining Favourability
A Seton
5 "My Rectum Is Falling Out!" - Rectal Prolapse
How Does a Rectum Fall Out?
What Do We Do About It?
6 "I Have Gas and Stool Coming Through My Vagina" - Obstetrical Trauma
Cause and Symptoms
When Surgery Is Required
7 "I Have, Um, Accidents" - Fecal Incontinence
Diagnosis - The Challenge
Managing Fecal Incontinence
Remedies
8 "I Think I've Got Warts" - Anogenital Warts, HPV, Anal Cancer
Warts, HPV, and Cancer
Frequently Asked Questions
9 "Something's Stuck Up There" - Social Injuries of the Rectum
No Laughing Matter
Removal Requires Imagination
10 "I Am Always Constipated" - Constipation
How It's Supposed to Work
Diagnosing a Complex Problem
Treatment Options
11 "I Have Diarrhea and Abdominal Pain" - Inflammatory Bowel Disease
Distinguishing Between IBDs
Curability
Ulcerative Colitis (UC)
Crohn's Disease (CD)
Fears and Questions
Will I Need a Bag?
Should I Take a Probiotic?
12 "Can I Ask You About This?" - Odds and Ends
Pooping and Farting
Let's Talk Pooping
There's a Scale for Poop?
... And Farting
Washing or Wiping
Anal Intercourse
Patient Embarrassment
13 "Can That Be Right?" - Myths Debunked
You Should Move Your Bowels Every Day
Hemorrhoids Are Painful
Surgical Removal Is the Main Treatment of Hemorrhoids, and They Come Back!
Colonoscopy Is a Miserable but Necessary Experience, and It's Dangerous
Colon Cancer Is a Cancer of Old Age
Colon Irrigations (Colonics) Get Rid of Toxins
14 "Do You Like What You Do?" - My Back Pages
A Special Specialty
The Surgical Ego
Master and Apprentice
Why I Do What I Do
Appendix: Top Ten Tips for Anal Health
Glossary
About the Author