Ch.11 - Anal Pain

Question 1

In terms of presenting symptoms, what’s the biggest difference between thrombosed external hemorrhoids vs perianal abscess?

Answer 1

Presence of systemic symptoms of infection - abscess

Question 2

Pain of short duration, visible hemorrhoids. What is it? What do you do?

Answer 2

Acute, possibly thrombosed hemorrhoids

Excise vs watch

Question 3

Sharp pain with each BM, minimal bleeding

Answer 3

Fissure.

Fiber supplements, topical calcium channel blockers

Lateral internal sohincterotomy

Question 4

Pain even without BM. fever, exam shows swelling, eeythmra

Answer 4

Abscessm drain

Question 5

Itching or pain worst after BM, visible skin changes

Answer 5

Pruritis Ani

Stop anal prep and wipes. Sitz bath, dry the stools with fiber

Possibly stool culture. Use moist barriers. Desitin

Question 6

Pain after sitting for a long time. Tenderness at the coccyx

Answer 6

Levator syndrome.

Biofeedback, physical therapy