title: Relationship between anal symptoms and anal findings.
abstract: BACKGROUND
  The frequencies and types of anal symptoms were compared with the frequencies and types of benign anal diseases (BAD).
  
  
  METHODS
  Patients transferred from GPs, physicians or gynaecologists for anal and/or abdominal complaints/signs were enrolled and asked to complete a questionnaire about their symptoms. Proctologic assessment was performed in the knee-chest position. Definitions of BAD were tested in a two year pilot study. Findings were entered into a PC immediately after the assessment of each individual.
  
  
  RESULTS
  Eight hundred seven individuals, 539 (66.8%) with and 268 without BAD were analysed. Almost one third (31.2%) of patients with BAD had more than one BAD. Concomitant anal findings such as skin tags were more frequently seen in patients with than without BAD (<0.01). After haemorrhoids (401 patients), pruritus ani (317 patients) was the second most frequently found BAD. The distribution of stages in 317 pruritus ani patients was: mild (91), moderate (178), severe (29), and chronic (19). Anal symptoms in patients with BAD included: bleeding (58.6%), itch (53.7%), pain (33.7%), burning (32.9%), and soreness (26.6%). Anal lesions could be predicted according to patients' answers in the questionnaire: haemorrhoids by anal bleeding (p=0.032), weeping (p=0.017), and non-existence of anal pain (p=0.005); anal fissures by anal pain (p=0.001) and anal bleeding (p=0.006); pruritus ani by anal pain (p=0.001), itching (p=0.001), and soreness (p=0.006).
  
  
  CONCLUSIONS
  The knee-chest position may allow for the accumulation of more detailed information about BAD than the left lateral Sims' position, thus enabling physicians to make more reliable anal diagnoses and provide better differentiated therapies.
authors.affiliation: Praxis für Endoskopie und Proktologie, Viktoria-Luise-Platz 12, 10777 Berlin, Germany.
authors.forename: Hans Georg
authors.initials: HG
authors.lastname: Kuehn
authors.forename: Ole
authors.initials: O
authors.lastname: Gebbensleben
authors.forename: York
authors.initials: Y
authors.lastname: Hilger
authors.forename: Henning
authors.initials: H
authors.lastname: Rohde
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D005401:Fissure in Ano / Q000150:complications* / Q000175:diagnosis; D006484:Hemorrhoids / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications*; D011538:Pruritus Ani / Q000150:complications*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires