Essendon Colorectal

06

Proctology (Anal & Perianal Conditions)

Specialist assessment and treatment of anal and perianal conditions, with attention to symptom relief, healing, and the preservation of continence.

Proctology covers conditions affecting the anus and surrounding perianal skin — including haemorrhoids, anal fissures, fistulas, abscesses, and pilonidal disease. These are common problems that can cause significant discomfort but are often treatable with straightforward, minimally invasive approaches. Dr Tiang provides specialist proctology care in Melbourne, offering both conservative and surgical management tailored to each patient's symptoms and circumstances. The priority is always symptom relief, complete healing, and preservation of continence and quality of life.

Sub-topics

01

Haemorrhoids (Piles)

Haemorrhoids are swollen veins in the anal canal and are one of the most common reasons patients seek specialist advice. Symptoms include bleeding during bowel movements, itching, discomfort, and in some cases a prolapsed lump. Treatment ranges from conservative measures such as dietary modification and topical agents, to minimally invasive procedures including rubber band ligation and injection sclerotherapy, through to surgical haemorrhoidectomy or haemorrhoidopexy performed without staples for more severe cases. The approach is tailored to symptom severity, the type of haemorrhoid (internal or external), and each patient's individual circumstances.

02

Anal Fissures

An anal fissure is a small tear in the lining of the anal canal that typically causes sharp pain during and after bowel movements, often accompanied by bright red bleeding. Initial treatment focuses on conservative measures such as dietary fibre, stool softeners, and topical muscle relaxants to relieve spasm and promote healing. Where fissures are chronic or unresponsive to medical therapy, surgical options such as a lateral internal sphincterotomy can provide effective and lasting relief while preserving continence.

03

Fistula-in-Ano

An anal fistula is an abnormal connection between the anal canal and the skin near the anus, usually forming after a perianal abscess has drained. Symptoms include recurrent discharge, irritation, and episodes of swelling or pain. Management is individualised to the fistula's anatomy and complexity, and may include fistulotomy, seton placement, or advanced techniques such as the ligation of intersphincteric fistula tract (LIFT) procedure. The goal is to eliminate the fistula while preserving continence.

04

Perianal Abscess

A perianal abscess is a collection of pus near the anus that causes pain, swelling, and often fever. Prompt assessment and drainage are essential to relieve symptoms, prevent the spread of infection, and reduce the risk of a subsequent fistula forming. Most abscesses can be drained under local or general anaesthetic as a day procedure, with follow-up to ensure complete healing.

05

Pilonidal Disease

Pilonidal disease is a chronic skin condition affecting the natal cleft (the cleft between the buttocks), where hair and skin debris can become trapped, leading to recurring cysts, sinus tracts, abscesses, and inflammation. It most commonly affects young adults and can cause painful, recurring episodes. Treatment ranges from drainage of acute abscesses to definitive surgical management of the pilonidal sinus, including minimally invasive techniques such as pit picking and the Gips procedure, through to excision with primary closure for more extensive disease. The aim is to achieve complete healing with minimal scarring and a low recurrence rate.

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