butt stuff Flashcards
what is colorectal cancer
cancer in colon or rectum
usually adenocarcinoma
arises from polyps
what are risk factors for colorectal cancer
male age smoking IBD red meat diet family history
how may colorectal cancer present
ascending colon - occult bleeding, iron deficiency anaemia, non-obstructive
descending colon - ring shaped tumour, abdominal pain, obstructive, constipation
abdominal pain
weight loss
fatigue
what investigations could you do for colorectal cancer
barium enema
colonoscopy
bowel cancer screening program
bloods - iron deficiency, CEA
how could you treat colorectal cancer
TNM staging
chemotherapy
radiotherapy
surgical resection
what are haemorrhoids
enlarged vessels in the anus that can be seen on the exterior
what causes haemorrhoids
usually constipation and straining
how can haemorrhoids present
pruritis blood or mucous on stool pain anaemia painless
what investigations could you do for haemorrhoids
examine abdomen and anus
sigmoidoscopy
colonoscopy
how could you treat haemorrhoids
advice - hydration, paracetamol, cut out alcohol and coffee, keep anus clean and dry, bath etc
normally resolves in a week
rubber band ligation - base of haemorrhoid is tied off to stop it’s blood supply
HALO
remove haemorrhoid
treat underlying cause - constipation
what is an anal fissure
a tear in the lining of the anus
what can cause an anal fissure
usually due to passing hard stools and constipation
how may an anal fissure present
pain while passing stools - ‘like passing glass splinters’
itching
blood on tissue/stool
lump, skin tag, visible tear
what investigations could you do for anal fissures
sigmoidoscopy - rule out cancer
how could you treat an anal fissure
manage constipation topical NO paste GTN/diltiazem botox to relax the sphincter clean the fissure sphincterotomy - take some of the internal sphincter away
what is an anal fistula
abnormal connection between anal canal and skin
what can cause a fistula
trauma perianal abscess chron's disease diverticular disease rectal carcinoma
how may a fistula present
pain/swelling fever weight loss diarrhoea sepsis pus discharge
how could you treat a fistula
it is difficult to treat
clean and drain it
can do a fistulotomy but risk of incontinence especially in women
what is anorectal cancer
squamous cancer in the anus or rectum
usually arises from pre-existing polyps - tubular or villous
what are risk factors for anorectal cancer
anal intercourse HIV HPV family history age male low fibre, high red meat and alcohol diet obesity smoking DM
how may anorectal cancer present
change in bowel habit iron deficiency anaemia fatigue weight loss bleeding pruritis pain anal mass/stricture on examination
what investigations could you do for anorectal cancer
colonoscopy with biopsy = 1st line CT sigmoidoscopy MRI FIT test - positive rectal exam
how could you treat anorectal cancer
chemotherapy
radiotherapy
palliate
what is a perianal abscess
large collection of pus/fluid in perianal area
how does a perianal abscess present
extreme pain
signs of sepsis
how do you treat a perianal abscess
antibiotics if needed
drain
what is pelvic floor dysfunction
spectrum of symptoms related to defecation
can be related to child birth, surgery, abuse, sepsis
