Anal Issues & achalasia Flashcards

1
Q

What is an anorectal abscess

A

Infection in anorectal tissue

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2
Q

Cause of anorectal abscess

A

Anal fistula
Crohns
Anal trauma

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3
Q

Signs and symptoms of anorectal abscess

A

Perianal pain
Perianal swelling
Fever

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4
Q

Treatment of anorectal abscess

A

Surgical drainage

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5
Q

What is an anal fistula

A

Abnormal open connection between the anal canal and the skin of the butt

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6
Q

Cause of anal fistula

A

Anorectal abscess (70%)
Crohns ulcerations (30%)

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7
Q

Signs and symptoms of anal fistula

A

Throbbing pain worse when sitting
Blood mucus in stool
Pruritus ani

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8
Q

Treatment for anal fistula

A

Surgery

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9
Q

What is an anal fissure

A

Tear in lower anal canal usually due to trauma

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10
Q

Cause of anal fissure

A

Constipation
Anal trauma
Crohns
TB

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11
Q

Signs and symptoms of anal fissure

A

Extreme pain on passing motion
Blood in stool/ on wiping

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12
Q

Treatment for anal fissure

A

Fluids and more fibre

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13
Q

What is a pilonidal sinus / abscess

A

Ingrown hair ~~ inflammation ~~ hole in skin ~~ infected

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14
Q

Define achalasia

A

degeneration of ganglions in auerbachs/ myenteric plexus

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15
Q

pathophysiology of achalasia

A

nerves in lower oesophageal sphincter do not work — LOS cannot relax — obstruction

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16
Q

clinical presentation of achalasia

A
  • dysphagia: unable to swallow BOTH solids and liquids
  • heart burn
  • food regurgitation
17
Q

How would you differentiate achalasia and oesophageal cancer

A

achalasia- cant swallow liquid and solid
cancer- cant swallow solids first then liquids over time

18
Q

what investigations would you do for suspected achalasia

A

endoscopy
barium swallow
manometry- GOLD

19
Q

what would barium swallow show for achalasia

A
  • dilated oesophagus
  • tight ‘birds beak’ LOS
20
Q

What is the treatment for achalasia

A
  • lifestyle- smaller but more frequent meals
  • nitrates or CCB to relax LOS
  • botox to relax LOS
    -Surgery , cardiomyopathy