Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Symptom | Clinical Features | Tests | Causes | Management |
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Perianal Pain |
- Severe, constant pain near the anus.
- Worse with sitting or defecation. - May be associated with swelling, warmth, and redness. |
- Clinical examination.
- Digital rectal examination. - Ultrasound or MRI if deep abscess suspected. |
- Perianal abscess.
- Anal fissure. - Thrombosed hemorrhoid. |
- Incision and drainage for abscess.
- Stool softeners and topical analgesia for fissures. - Excision or conservative management of thrombosed hemorrhoid. |
Perianal Discharge |
- Persistent or intermittent discharge of pus or fecal material.
- Associated with itching and skin irritation. - May be accompanied by swelling or abscess. |
- Clinical examination.
- Digital rectal examination. - MRI or endoanal ultrasound to delineate fistula tract. |
- Perianal fistula.
- Inflammatory bowel disease (Crohn’s disease). |
- Fistulotomy or seton placement for fistula.
- Treat underlying IBD (e.g., immunosuppressive therapy). |
Perianal Itching (Pruritus Ani) |
- Intense itching around the anus.
- May be worse at night or after bowel movements. - Red, excoriated skin. |
- Clinical examination.
- Stool examination for pinworms. - Patch testing for contact dermatitis. |
- Dermatitis (contact, atopic).
- Fungal infection (e.g., candidiasis). - Pinworm infection (Enterobius vermicularis). |
- Topical antifungal or steroid creams.
- Treat underlying infection (e.g., antihelminthic for pinworms). - Avoid irritants and maintain hygiene. |
Perianal Swelling |
- Localized swelling or lump near the anus.
- May be tender to touch. - Associated with pain, redness, and possibly pus drainage. |
- Clinical examination.
- Digital rectal exam. - Ultrasound for deeper swelling. |
- Perianal abscess.
- Thrombosed external hemorrhoid. - Anal cancer (rare, if persistent). |
- Incision and drainage for abscess.
- Conservative management or excision for hemorrhoid. - Biopsy if malignancy suspected. |
Bleeding |
- Bright red blood on toilet paper or in stool.
- Pain during defecation (e.g., with fissures). - Painless bleeding with hemorrhoids. |
- Anoscopy or sigmoidoscopy to assess anal canal.
- Proctoscopy to evaluate hemorrhoids or fissures. - Colonoscopy if IBD or malignancy suspected. |
- Anal fissure.
- Hemorrhoids. - Inflammatory bowel disease. |
- Stool softeners and topical treatment for fissures.
- Rubber band ligation or sclerotherapy for hemorrhoids. - Treat underlying IBD with medical therapy. |