Anorectal Disorders

Abstract

Anorectal disorders encompass structural, neuromuscular, and functional disorders. They are common, often distressing, and in some cases debilitating, and significantly add to the health care burden. They present with multiple, overlapping symptoms that can often obscure the underlying pathology and can pose significant diagnostic and management dilemmas. A meticulous history and comprehensive digital rectal examination can provide clarity on the diagnosis, appropriate testing, and management of these conditions. Today, with the development of sophisticated diagnostic tools such as high-resolution and high-definition (3-D) anorectal manometry, 3-D anal ultrasonography, magnetic resonance defecography and imaging, and neurophysiological tests such as translumbosacral anorectal magnetic stimulation, it is possible to more accurately define and characterize the underlying structural and functional abnormalities. In this review, we present a succinct update on the latest knowledge with regards to the pathophysiology, diagnosis and management of anal fissure, hemorrhoids, rectal prolapse, intussusception, rectocele, solitary rectal ulcer syndrome, levator ani syndrome, dyssynergic defecation and fecal incontinence.

Pain Trajectory after Short-Stay Anorectal Surgery: A Prospective Observational Study

“…This may be related to the location of the occurrence. Hemorrhoids generally occur in the most sensitive areas of the rectum and anal canal, whereas anal fistulas mostly occur in the anal soft tissue outside the operation area [ 5 , 27 , 28 ]. Our regression results also revealed a correlation between postoperative pain trajectory and preoperative anxiety and pain behavior scores.…”

Diagnosis and management of fecal incontinence in children and adolescents

“…The internal anal sphincter, external anal sphincter, and puborectalis muscle are all involved in the anal canal closure function ( 10 ). The external anal sphincter is the most powerful part of the mechanism that closes the anal canal when it contracts.…”

Comparative Study of Surgical Treatment with Abdominal and Perineal Approaches in Patients with Rectal Prolapse

“…Prolapse can be either complete when the entire rectal wall protrudes through the anal canal or incomplete when the rectal wall has fallen out but does not protrude through the back passage. Also, experts identify prolapse of only the mucous membrane of the rectum or anal canal (Xiao et al, 2018;Kulikovsky et al, 2019;Trompetto et al, 2019;Rao & Tetangco, 2020;Gramellini et al, 2021).…”

“…RP occurs more often in adult women (Madbouly & Mohii, 2019;Rao & Tetangco, 2020). In the adult population, the peak incidence occurs in the fifth decade and is more common in women (80-90%) (Madbouly & Mohii, 2019;Rao & Tetangco, 2020).…”

“…RP occurs more often in adult women (Madbouly & Mohii, 2019;Rao & Tetangco, 2020). In the adult population, the peak incidence occurs in the fifth decade and is more common in women (80-90%) (Madbouly & Mohii, 2019;Rao & Tetangco, 2020). In RP, an impaired adaptation of the rectum to stretching can contribute to anal incontinence, and more than half of patients have concomitant urinary incontinence (Alkatrani & Basrah, 2021;Brown et al, 2022;D'Hoore, 2022).…”