Rectal And Anal Disorders Flashcards
Whats an anal fissure
Tear or ulcer in anal canal lining
Anal fissure symptoms
Bleeding
Persistent pain when defecating
Linear Split in anal mucosa
acute anal fissure duration
< 6 weeks
Chronic anal fissure duration
> 6 weeks
Acute anal fissure treatment
Bulk forming and osmotic laxatives to prevent constipation and straining
Simple Analgesia- paracetamol, ibuprofen for pain after defecating
Local anaesthetic - lidocaine short term use
Chronic fissure treatment
GTN (rectogesic)
Or
Oral/ topical diltiazem/ nifedipine
SE of rectogesic
Headaches
Whats haemorrhoids/ piles
Abnormal swelling of vascular mucosal around anus
What are the two types of haemorrhoids
Internal - painless unless they get strangulated- bleeding
External- itchy or painful
External haemorrhoids are common in …..
Pregnant women
A pregnant woman with haemorrhoids, avoid which drugs …..
Local anaesthetic- lidocaine, benzocaine,cinchocaine, pramocaine
Steroids
Management of haemorrhoids
Topical local anaesthetic
Laxatives
Topical corticosteroids, astringents, lubricants
Increase in fibre and fluids to prevent constipation
Good perianal hygiene
Can you give opioids for pain in haemorrhoids
No because they cause constipation, give paracetamol or ibuprofen (avoid NSAID if theres bleeding)
Can you give NSAIDs for haemorrhoids pain
Only if theres no bleeding as they increase risk of bleeds
How long can you use topical local anaesthetic for?
Only a FEW DAYS as they cause sensitisation of anal skin
Avoid excessive application
