title: Haemorrhoids, rectal prolapse, anal fissure, peri-anal fistulae and sexually transmitted diseases.
abstract: Anorectal disorders like haemorrhoids, rectal prolapse, anal fissures, peri-anal fistulae and sexually transmitted diseases are bothersome benign conditions that warrant special attention. They, however, can all be diagnosed by inspection or proctoscopy (sexually transmitted proctitis). Constipation can play an underlying role in haemorrhoids, rectal prolapse and anal fissures, and it is important to treat these conditions in order to avoid recurrences. Haemorrhoids and anal fissures are generally treated conservatively and surgery is seldom required. Rectal prolapse and cryptoglandular peri-anal fistulae are treated surgically. In a recurrent peri-anal fistula, the fistular tract needs to be visualised with anal ultrasound or magnetic resonance imaging (MRI). There are different techniques available for this evaluation, and care must be taken not to damage the anal sphincter. Peri-anal fistulae in Crohn's disease are treated conservatively and surgery is only required in cases with abscesses. Sexually transmitted proctitis needs to be adequately recognised and treated according to the infectious agent.
authors: Department of Gastroenterology, University Hospital Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. rjf.felt@vumc.nl
authors: Richelle J F
authors: RJ
authors: Felt-Bersma
authors: Joep F
authors: JF
authors: Bartelsman
mesh_terms: D005260:Female; D005401:Fissure in Ano / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006484:Hemorrhoids / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D012003:Rectal Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012005:Rectal Prolapse / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012008:Recurrence; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome