title: Anorectal symptoms during pregnancy: how important is trimester?
abstract: OBJECTIVE
  The frequency of anorectal symptoms amongst pregnant women has not been objectively investigated in the United Kingdom. The aim of this study was to determine the frequency of anorectal symptoms during each trimester of pregnancy.
  
  
  METHODS
  Women attending the antenatal clinics at a London teaching hospital were asked to complete a questionnaire. The presence or absence of common anorectal symptoms experienced both before and during the current pregnancy together with demographic and pregnancy data was collected. Statistical analysis was performed using Fisher's exact test.
  
  
  RESULTS
  Two hundred seventeen patients (first trimester n=75, second trimester n=70 and third trimester n=72) participated. A significant increase in the frequency of symptoms was observed in the third (43.1%) compared to the first (16.0%, p<0.001) and second (22.9%, p=0.013) trimesters. The incidence of per rectal bleeding was significantly greater in the third trimester (30.6%) compared to the first (10.6%, p=0.004) and the second (12.9%, p=0.014) trimesters. Similarly, anal pain was significantly more frequent in the third trimester (34.7%) compared to the first (13.3%, p=0.003) and the second (12.9%, p=0.003) trimesters.
  
  
  CONCLUSIONS
  The frequency of anorectal symptom reporting appears to increase as pregnancy progresses. Further investigation and research is warranted to determine the configuration of services that may be required to treat those affected.
authors.affiliation: Department of Biosurgery and Surgical Technology, Faculty of Medicine, Imperial College, London, UK.
authors.forename: Samit N
authors.initials: SN
authors.lastname: Unadkat
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Leff
authors.forename: Tiong-Ghee
authors.initials: TG
authors.lastname: Teoh
authors.forename: Raj
authors.initials: R
authors.lastname: Rai
authors.forename: Ara W
authors.initials: AW
authors.lastname: Darzi
authors.forename: Paul
authors.initials: P
authors.lastname: Ziprin
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000473:pathology*; D003710:Demography; D005260:Female; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011264:Pregnancy Trimesters; D012007:Rectum / Q000473:pathology*; D006113:United Kingdom / Q000453:epidemiology