Although it is still a taboo subject among people, there are several problems that can affect the anus region. These include hemorrhoids—a relatively common condition—, fissures (a cut), and colorectal cancer. But there is still another condition, not so well known, that can be confused with other diseases, which is the case of anal plicoma, an excess of skin on the edge of the anus.
This condition, which does not usually cause serious health problems, can resemble hemorrhoids and leave the patient confused. But they are two different things, which tend to be associated, according to doctors.
“The external hemorrhoid can result in plicoma, but the plicoma does not turn into a hemorrhoid”, explains Bruno Martins, coloproctologist at Hospital Brasília (DF). “When there is an external hemorrhoid crisis, that ‘ball’ appears at the edge of the anus and, when it deflates and regresses, this accumulation of skin may remain, which we call plicoma.”
Remembering that hemorrhoid is a disease that can cause bleeding and pain in the anus region. It occurs due to swelling and inflammation of the veins that pass through the site – unlike plicoma, which is an accumulation of skin and not veins. Therefore, external — not internal — hemorrhoids are the most common cause of plicoma.
According to Denise Priolli, coloproctologist and coordinator of Faculdade Pitágoras in Codó, Maranhão, plicoma is usually a “sequel” or a sign that something has happened in the region. “It is a scar on the anal edge, which is the result of processes such as inflammation, a cut or an external hemorrhoid”, reinforces the doctor who is also a specialist in surgical gastroenterology.
Priolli also explains that plicoma is almost like a form of protection for the body, a way to prevent that region – already affected – from causing even more pain in the person. “This excess of skin means that, when opening and closing the anus, a normal mechanism for the elimination of feces, there is no other cut on the scar”, she says.
Can other situations cause plicoma to arise?
Although it is not as common, people with IBDs (inflammatory bowel diseases), such as Crohn’s disease and ulcerative colitis, can develop plicomas, as well as pregnant women, who are at greater risk of having hemorrhoids.
Excess skin can also appear in other situations: when there is a cut (fissure) in the region or right after a hemorrhoid removal surgery — in this case, as a scar from the treatment.
Therefore, it is always important to look for the doctor who will investigate and suggest the best way to treat, in addition to giving guidance on cleaning the place.
Even without offering health risks, the condition can bring discomfort, as plicomas can have different sizes. When it is large, the patient tends to feel more uncomfortable.
“In some cases, it is difficult to clean, leaving the area dirty and causing itching (pruritus). In addition, it can cause the sensation of swelling. So, we have from aesthetic to functional manifestations”, explains Pedro Popoutchi, proctologist at BP – The Portuguese Beneficence of São Paulo. Another common sign is a feeling of blockage in the anus.
Also according to the doctor, something that is not usually frequent with plicomas is bleeding. “When there’s blood, most of the time, it’s something internal, like a hemorrhoid. But it’s also important to remember that not all bleeding is because of the hemorrhoid,” he says.
This means that bleeding from the anus can be an important warning sign to go to the doctor, as it is an important symptom of colorectal cancer. But the warning is for any change in the region, even if it’s a “simple” plink.
“Although it is something common, it is always important to seek a doctor to make this distinction, as it is possible to confuse plicomas with HPV lesions, ulcers and fissures”, reinforces the doctor at Hospital Brasília.
Is it possible to treat plicoma
But there is no ointment or remedy that will remove excess skin. If the person is very uncomfortable, the only option is the removal surgery, as explained by Vanessa Prado, digestive system surgeon at the Digestive System Specialties Center at Hospital Nove de Julho (SP) and member of the SBC (Brazilian Society of Coloproctology) .
“Even though it’s nothing serious, there are tiny plicomas, which the doctor doesn’t even recommend removing, but there are large ones, which can bring discomfort and, in this case, we can recommend removal”, he says.
According to experts, it is a low-complexity surgery, in which the patient tends to be released on the same day, with a quick recovery.
What are the forms of prevention?
As (external) hemorrhoids are the main cause of plicoma, prevention involves the following practices:
- Avoid sitting in the bathroom for a long time;
- Eat a high fiber diet;
- Drink water;
- Practice physical activity;
- Avoid excess alcohol, pepper and other condiments;
- Clean the anus with water, if possible, or a moistened tissue, avoiding the use of toilet paper.