title: Anal Health Care Basics.
abstract: Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area.Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases.In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists.
authors.affiliation: General Surgery Resident completing his training at the Los Angeles Medical Center. jason.s.chang@kp.org.
authors.forename: Jason
authors.initials: J
authors.lastname: Chang
authors.affiliation: Board-Certified Colorectal Surgeon, Chief of Colorectal Surgery, and Director of Minimally Invasive Surgery at the Los Angeles Medical Center in CA. elisabeth.c.mclemore@kp.org.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Mclemore
authors.affiliation: Board-Certified General Surgeon with a special interest in anal health care at the Los Angeles Medical Center in CA. talar.x.tejirian@kp.org.
authors.forename: Talar
authors.initials: T
authors.lastname: Tejirian
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000628:therapy; D001003:Anal Canal / Q000473:pathology*; D001004:Anus Diseases / Q000175:diagnosis / Q000628:therapy; D003672:Defecation; D004043:Dietary Fiber; D005242:Fecal Incontinence / Q000175:diagnosis / Q000628:therapy; D005401:Fissure in Ano / Q000175:diagnosis / Q000628:therapy; D006484:Hemorrhoids / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D010808:Physical Examination; D011538:Pruritus Ani / Q000175:diagnosis / Q000628:therapy; D012002:Rectal Diseases / Q000175:diagnosis / Q000628:therapy*; D012003:Rectal Fistula / Q000175:diagnosis / Q000628:therapy; D012007:Rectum / Q000473:pathology*