Anorectal Disease Flashcards
What are haemorrhoids?
Swollen vessels, usually veins, in/around the rectum and anus
Painful bleeding usually occurs with haemorrhoids. True/False?
False
Classically painless bleeding
Is there usually weight loss + change in bowel habit associated with haemorrhoids?
No
List investigations for haemorrhoids
PR exam
Rigid sigmoidoscopy
Flexible sigmoidoscopy in pts older than 50
Proctoscopy
List treatment for symptomatic haemorrhoids
Scleroant therapy Ice packs, gel, cream Band ligation Haemorrhoidectomy Artery ligation
Why is haemorrhoidal artery ligation essentially pain-free?
Little/no sensory neurones in lower rectum
What is rectal prolapse?
Protruding mucosal mass from anus, usually during defecation
Rectal prolapse causes loss of anal tone. True/False?
True
Most patients are unable to undergo surgery for rectal prolapse. True/False?
True
What are anal fissures?
Tear in the anal margin during passage of (constipated) stool
Anal fissures are most commonly associated with ulcerative colitis. True/False?
False
More likely to be with Crohn’s disease
How do anal fissures classically present?
Acute onset of anal pain following passage of constipated stool
Feels like shitting a shard of glass
List treatment for anal fissure
Stool softener, diet advice Pharmacological sphincterotomy (relax sphincter using diltiazem)
What is fistula in ano?
Abnormal epithelial connection between anal canal + peri-anal skin
Which conditions have a rare association with anal fistulas?
Tuberculosis
Crohn’s disease
Carcinoma
