- Fistulae are well-recognised complication of Crohn's disease
- Full rectal examination is important to detect other causes of fistula in ano e.g. rectal carcinoma
Fissure in ano
- Very painful, rectal examination not possible
- Constipated because defecation is so painful
- Vicious cycle as the stools become harder, resulting in defecation becoming more difficult and painful
Pilinoidal sinus
- Always occur in the midline of the natal cleft
- More common in men than in women
Haemorrhoids
- Spongy vascular tissue surrounds and helps close the anal canal
- If they cushions enlarge they can prolapse and bleed to form haemorrhoids/piles
- First-degree haemorrhoids remain in the rectum
- Second-degree haemorrhoids prolapse through the rectum on defecation but spontaneously reduce
- Third-degree haemorrhoids remain prolapsed
- Constipation, need high fibre diet
Perianal warts
- Human papilloma virus (HPV) infection is responsible for anogenital warts and is particularly associated with unprotected sexual contact
- Look out for the appearance of such lesions in immunocompromised individuals
- HPV-related warts are referred to as condylomata acuminata
- Condyloma lata are broad-based, flat-topped and necrotic papules that occur with secondary syphilis
- Condyloma lata must be differentiated from condylomata acuminata (biopsy?)
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