ano rectal disorder

Question 1

investigations taken place- haemmoroids?

Answer 1

• PR exam
• rigid sigmoidoscopy
• protoscopy (1st line)
• flexible sigmoidoscopy in patients >50 (1st line)

Question 2

management of haemmorroids?

Answer 2

• diet first line (avoid constipation + creams)
• rubber band ligation
• open haemorrhoidectomy (for large haemorrhoids)
• stapled haemorrhoidectomy

Question 3

what types rectal prolapse?

Answer 3

• partial

- full

Question 4

management of complete rectal prolapse?

Answer 4

• many patients too frail for surgery so have bulking agent and education on manual reduction
• Delorme’s procedure
• Perineal rectopexy
• Abdominal rectopexy
• Anterior resection

Question 5

managment incomplete prolapse in children?

Answer 5

• dietary advice + treatment for constipation

- in adults treat similar to haemorrhoids

Question 6

cause of prolapse?

Answer 6

weak pelvic floor

Question 7

what is an anal fissure?

Answer 7

-tear in the anal margin due to passage of contraption

Question 8

presentation of anal fissure?

Answer 8

• acute severe pain when shitting

- feels like glass

Question 9

treatment of anal fissure?

Answer 9

• dietary advice
• stool softener
• pharmacological sphincterotomy (GTN, Diltiazem) to allow sphincter relaxation
• lateral sphincterotomy
• botox injection

Question 10

fisure management

Answer 10

• laying open
• two stage procedure
• Insertion of seton (draining + cutting)
• LIFT procedure
• glue/paracetamol