Common anorectal disorders

Anorectal disorders are extremely common and are often manifest in the psychiatric patient population. While most conditions are self-limited, there are a variety of problems, from hemorrhoids to infection and venereal disease, that demand diagnosis and treatment. The patient is often unaware of the true nature of the problem and frequently attributes his or her symptoms to “hemorrhoids.”

The distal rectum and anal canal are the location of most of the pathology discussed below. Examination consists of inspection of the perianal area, digital examination, and instrumentation with anoscopy and sigmoidoscopy. Most conditions are readily apparent. The examiner must always keep in mind that many common symptoms of anal rectal disorders such as bleeding, pain, and discharge, can be signs of malignancy.

Conditions to be discussed include hemorrhoids, fissure in ano, fistulas, abscesses, pruritus ani, pilonidal sinus, condylomata acuminatum, and other venereal infections. This list includes the most common disorders with which the general physician will be confronted. Discussion will be directed toward identification and appropriate therapy.