Before We Treat, We Investigate
Anorectal conditions — hemorrhoids, fissures, fistulas, pilonidal sinus — are among the most common reasons patients seek surgical consultation. Many of these conditions are straightforward to treat. But the question that matters is not just "what do you have?" — it is "what else might be going on?" At our practice, Dr. Khaled Ghalwash orders a colonoscopy before proceeding with any anal surgery. The reason is simple: patients who present with rectal bleeding or chronic anal symptoms sometimes have underlying conditions — colitis, diverticular disease, polyps, or even early-stage colorectal cancer — that would change the entire treatment plan. A 20-minute diagnostic procedure can prevent months of mismanagement.
التشخيص الصح قبل العلاج — لازم نعرف السبب الاول قبل ما نبدأ اي تدخل جراحي
Conditions We Treat
الحالات اللي بنعالجها
Our anorectal surgery practice covers the full spectrum of conditions affecting the anal canal and perianal region. Each condition has its own page with detailed information about diagnosis and treatment options:
Hemorrhoids (البواسير): The most common anorectal condition. Not all hemorrhoids need surgery — grades 1 and 2 often respond to conservative treatment. Grades 3 and 4 typically require surgical intervention. We offer multiple techniques including stapled hemorrhoidopexy and conventional excision, chosen based on the individual case.
Anal Fissure (الشرخ الشرجي): A tear in the anal lining that causes sharp pain and bleeding. Most acute fissures heal with medical treatment. Chronic fissures that fail conservative management may require lateral internal sphincterotomy — a precise procedure with high success rates.
Anal Fistula and Perianal Abscess (الناسور الشرجي والخراج): Fistulas are abnormal tunnels between the anal canal and the skin surface, often originating from a perianal abscess. These require surgical treatment — the key is identifying the correct internal opening and choosing the right technique to prevent recurrence.
Pilonidal Sinus (الناسور العصعصي): A chronic condition affecting the sacrococcygeal area, common in young males. Recurrence rates vary widely depending on surgical technique — choosing the right approach the first time matters significantly.
Why Colonoscopy Before Anal Surgery?
ليه المنظار قبل جراحة الشرج؟
This is the single most important principle in our anorectal surgery practice: diagnose before you operate. A patient who presents with rectal bleeding and visible hemorrhoids may seem like a straightforward case. But rectal bleeding has many causes, and hemorrhoids can coexist with other conditions that are far more consequential.
Inflammatory bowel disease: Patients with undiagnosed Crohn's disease or ulcerative colitis may present with what appears to be a simple fissure or fistula. Operating without knowing about underlying colitis can lead to poor wound healing, non-healing fistulas, and worsened disease. A colonoscopy reveals mucosal inflammation that changes both surgical planning and medical management.
Colorectal polyps: Adenomatous polyps are precursors to colorectal cancer. They are often asymptomatic and discovered incidentally during colonoscopy. Removing them during the diagnostic procedure is both preventive and potentially life-saving.
Diverticular disease: Diverticulosis can cause bleeding that mimics hemorrhoidal bleeding. Identifying diverticula changes the treatment approach and helps patients understand the true source of their symptoms.
Colorectal cancer: In a small but significant number of patients, what appears to be hemorrhoidal bleeding turns out to be an early-stage malignancy. Early detection through colonoscopy dramatically improves outcomes. This is why we consider colonoscopy a non-negotiable step before elective anal surgery — it protects the patient.
التشخيص الصح قبل العلاج — مش كل بواسير محتاجة عملية
Our surgical services also include:
- Bariatric surgery — gastric sleeve, SASI bypass for weight management
- Thyroid surgery — thyroidectomy with nerve monitoring
- Gallbladder surgery — laparoscopic cholecystectomy
- Rhinoplasty — cosmetic and functional nasal surgery
- Breast augmentation and reduction
- Liposuction — body contouring and fat removal
- Financing options available for all procedures
