Anorectal Disease

Bleeding, pain, discharge, or change in bowel habits can indicate active anorectal disease, and all warrant medical evaluation. The patient history and a complete anorectal examination lead to a clear diagnosis in most complaints. Inflamed internal hemorrhoids or rectal polyps typically cause painless rectal bleeding. Painful anal bleeding can result from anal fissures, proctitis, thrombosed external hemorrhoids, or a draining perianal abscess. Palpable chronic masses can indicate an anal skin tag, polyp, or prolapsed rectal mass, and acute masses are usually caused by abscesses or thrombosed hemorrhoids. More than 90% of anorectal complaints can be managed in the primary care physician's office using simple techniques (Pfenninger and Zainea, 2001).

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