Anal Warts: Symptoms, Treatment, and Cancer Concerns

Warts growing inside the anus?

Hello, Doctor Jiang.
I have had warts around my anus for about two years.
I previously underwent electrosurgery, which improved my condition, but it recurred a few months later.
After researching online, I purchased LedaMed and used it at home, which helped, leaving only three or four small lesions near the anus.
However, I later discovered a larger wart, about two to three centimeters, inside the anal canal.
I have also been using LedaMed for this, but it doesn't seem to be effective.
I am worried that it may have been growing inside for one to two years and whether this could lead to colorectal cancer, especially since I have a family history of it.
Additionally, I have been experiencing some unusual abdominal symptoms, such as mucus in my stool and thin, string-like stools.
However, I am afraid my family will find out about my condition.
Could you please advise me on where to get checked—should I go to a large hospital or a general outpatient clinic? Will treatment require hospitalization, and what would the approximate costs be? Thank you very much.

Xiao Hei, 30~39 year old female. Ask Date: 2006/11/23

Dr. Jiang Zheen reply Dermatology

If the cauliflower-like growth is located deeper inside the anus, you should visit a major hospital's colorectal surgery department for treatment and undergo a sigmoidoscopy to check for any lesions that may have developed internally.
Most cauliflower-like growths are benign and do not change significantly; however, larger ones or those that have been present for a long time have a higher chance of becoming malignant.
Generally, hospitalization is not required unless there are many deep lesions, in which case hospitalization may be necessary.
As for the costs, I am not certain.
Wishing you peace; Jesus loves you.

Reply Date: 2006/11/23

More Info

Understanding anal warts, also known as condylomata acuminata, is crucial for managing symptoms and addressing potential cancer concerns. Anal warts are caused by certain strains of the human papillomavirus (HPV), which is a sexually transmitted infection. These warts can appear as small, fleshy growths around the anal area and can sometimes spread to the anal canal.

In your case, it seems that you have been dealing with anal warts for about two years, and despite undergoing treatments such as electrosurgery and topical medications like imiquimod (referred to as "樂得美"), the warts have recurred. This is not uncommon, as HPV can remain dormant in the body and lead to the reappearance of warts even after treatment. The presence of a larger wart inside the anal canal is concerning, especially given your family history of colorectal cancer and your recent gastrointestinal symptoms, such as mucus in your stool and changes in bowel habits.

It is essential to understand that while anal warts themselves are not cancerous, certain high-risk strains of HPV are associated with an increased risk of anal cancer. The symptoms you describe, particularly the changes in your bowel movements and the presence of mucus, warrant further investigation. It is advisable to seek a thorough evaluation by a healthcare professional, preferably a gastroenterologist or a colorectal surgeon, who can perform a digital rectal examination and possibly a colonoscopy to assess the anal canal and rectum for any abnormalities.

Regarding your concerns about whether you should go to a large hospital or a general outpatient clinic, it would be best to choose a facility that has experience in treating anal conditions and performing colorectal examinations. A larger hospital may offer more specialized care and access to advanced diagnostic tools, such as high-resolution anoscopy, which can help visualize the anal canal more clearly and identify any precancerous changes.

As for the treatment, if the warts are confirmed to be HPV-related, various options are available, including cryotherapy, laser treatment, or surgical excision, depending on their size and location. In some cases, hospitalization may not be necessary, especially for outpatient procedures. However, if there are concerns about the extent of the lesions or if a more invasive procedure is required, a short hospital stay may be needed.

In terms of costs, this can vary widely based on your location, the specific healthcare facility, and whether you have insurance coverage. It is advisable to contact the hospital or clinic directly to inquire about the expected costs for consultations, diagnostic procedures, and treatments.

Lastly, it is understandable to feel apprehensive about discussing these issues with family members. However, prioritizing your health and seeking medical advice is crucial. Early detection and treatment of any potential issues can significantly improve outcomes, especially given your family history of colorectal cancer. Do not hesitate to reach out to a healthcare provider for the necessary evaluations and support.

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