Anorectal Disorders

Anorectal disorders account for a large number of general surgical outpatient referrals but also a disproportionate number of acute presentations because of acute pain or sepsis or both. The vast majority are considered minor conditions. Symptoms are frequently severe, and the description of minor is often not shared by the patient. Bleeding as a symptom is frequently alarming to patients, and cautious evaluation and appropriate examination are of obvious importance. Much of the diagnosis is made with simple digital examination and proctoscopy, but the exclusion of upstream pathology, which may be causing symptoms or simply co-existent, should be emphasized. Once made, a diagnosis of a minor anorectal condition is often best treated with conservative, medical, dietary or lifestyle measures with surgical intervention only in refractory cases. Some, however, are best treated surgically from the outset.