Anorectal Disorders

Anorectal Disorders

 

Definition

Anorectal disorders are a group of medical disorders that occur at the junction of the anal canal and the rectum.

Description

The anal canal, also called the anus, is the opening at the bottom end of the digestive tract and is a combination of external skin and tissue from the digestive tract. It has many sensory nerves and is sensitive to pain. The rectum is the last section of the digestive tract and has a mucus layer as its inside surface. It has very few sensory nerves and is, therefore, relatively insensitive to pain. The anal canal has a ring of muscle, called the anal sphincter, which keeps the anus closed. There are a number of different anorectal disorders.

Causes and symptoms

An anal fissure is a tear in the lining of the anus that is usually caused by a hard bowel movement. Fissures are painful and bleed when the tissue is stressed during bowel movements.
Anorectal abscesses are characterized by pusforming infections in the anorectal region. Painful abscesses form under the skin.
An anorectal fistula is an abnormal opening or channel from the anorectal area to another part of the body. Typically, the channel leads to pockets of skin near the anus. When seen in infants, anorectal fistulas are considered birth defects. These are seen more frequently in boys than in girls. Fistulas are also seen more frequently in people who have other diseases, including Crohn's disease, tuberculosis, cancer, and diverticulitis. Anorectal fistulas also occur following anorectal abscesses or other injury to the anal area. Fistulas are usually painful and discharge pus.

Diagnosis

Diagnosis is made by visual inspection of the skin around the anus. Also, the doctor may probe the rectum with a gloved finger. An anoscope is a short instrument that allows the physician to view the inside of the anus. A proctoscope is a longer, rigid viewing tube of approximately six to ten inches in length, which may be used to look for anorectal disorders. A sigmoidoscope is a longer, flexible tube, that allows the physician to view up to about two feet of the inside of the large intestine. Tissue samples and material for microbial culture may be obtained during the examination.

Treatment

Treatment usually isn't required for hemorrhoids. Most hemorrhoids will heal if the patient takes stool softeners to relieve the constipation. Enlarged blood vessels can be eliminated by surgery if they are considered a severe problem. In the case of fissures, treatment involves stool softeners that eliminate stress on the fissure during bowel movements, which allows the fissure to heal. If the fissure doesn't heal, surgery is required. Treatment for anorectal abscesses consists of cutting the abscess and draining the pus. Fistulas are treated by surgery. The usual treatment for proctitis is antibiotics.

Resources

Books

Berkow, Robert, editor. Merck Manual of Medical Information. Whitehouse Station, NJ: Merck Research Laboratories, 1997.
References in periodicals archive ?
It is recommended by colon and rectal surgeons nationwide and works quickly to help relieve pain, itching and burning associated with hemorrhoids and other anorectal disorders.
What every gastroenterologist needs to know about common anorectal disorders.
Before considering operative treatment, other anorectal disorders must be ruled out, especially Hirschprung disease.
San Francisco, CA; 650-616-2200) announced that the United States Patent and Trademark Office has issued a patent (United States 6,395,736) that covers methods of treating anorectal disorders by administering certain concentrations of topical potassium channel openers to the anorectal region in order to decrease abnormally high pressure of the anal sphincter muscle.
Patients with inactive Crohn's disease or ulcerative colitis often have independent, functional bowel and anorectal disorders, Dr.
It works very quickly to relieve pain, itching and burning associated with hemorrhoids and other anorectal disorders.
A simple paradigm shift has brought the management of many benign anorectal disorders within reach of a well-appointed office.
Surgery also improves PA secondary to anorectal disorders such as fissures, extramammary Paget disease, fistulas, and abscesses.
Ferndale Healthcare[TM] specializes in markets encompassing disease states ranging from benign anorectal disorders to skin conditions.
a specialty pharmaceutical company engaged in developing and commercializing prescription drug products has special expertise in the treatment of respiratory symptoms, external otitis, muscular contraction headache, anorectal disorders, and bacterial vaginosis.
a specialty pharmaceutical company engaged in developing and commercializing prescription drug products, with special emphasis on the treatment of respiratory symptoms, external otitis, muscular contraction headache, anorectal disorders, and bacterial vaginosis.