Presentation on theme: "‘A pain in the backside’ Kamal Patel. Anorectal conditions in GP Aims –Overview of the anatomy –Common causes of anal pain and mx –Functional anal pain."— Presentation transcript:
‘A pain in the backside’ Kamal Patel
Anorectal conditions in GP Aims –Overview of the anatomy –Common causes of anal pain and mx –Functional anal pain Considerations –A common problem. –Source of embarrassment for patient (and GP in some cases!).
History Age of patient. Duration of symptoms. Associations –Bleeding –Discharge Timing of pain –Defacation –Sitting Related symptoms –Change of bowel habit. Sinister features –Weight loss
Levator ani syndrome Prevalence 6.6% More common in women. PC: vague ache or pressure in rectum; worse on sitting. Diagnosis of exclusion. Mx: –‘digital massage of the levator ani’ –Sitz baths –Electrogalvanic stimulation –Biofeedback training.
Proctalgia Fugax Severe cramp-like pain in the rectum Short duration Diagnosis of exclusion ‘Many patients are perfectionistic, anxious, and/or hypochondriacal’ Mx – reassurance. ?inhaled salbutamol