Cryptitis: Difference between revisions
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==Background== | ==Background== | ||
*Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent diarrhea, or passage of large/hard stools. | *Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent [[diarrhea]], or passage of large/hard stools. | ||
*Pathophysiology | *Pathophysiology | ||
**Anal crypts are mucosal pockets that lie between the columns of Morgagnia | **Anal crypts are mucosal pockets that lie between the columns of Morgagnia | ||
| Line 20: | Line 20: | ||
*Anoscopy shows inflammation, erythema, and pus | *Anoscopy shows inflammation, erythema, and pus | ||
==Management== | ==Management== | ||
#Bulk laxatives, additional roughage, sitz baths (treats underlying cause) | #Bulk [[laxatives]], additional roughage, sitz baths (treats underlying cause) | ||
#Surgical referral is indicated when: | #Surgical referral is indicated when: | ||
#*Infection has progressed and the crypt will not drain adequately on its own | #*Infection has progressed and the crypt will not drain adequately on its own | ||
Revision as of 20:18, 29 September 2019
Background
- Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent diarrhea, or passage of large/hard stools.
- Pathophysiology
- Anal crypts are mucosal pockets that lie between the columns of Morgagnia
- Formed by the puckering action of the sphincter muscles
- Superficial trauma (diarrhea, trauma from hard stool) → breakdown in mucosal lining
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
- Can lead to anal fissure, anal fistula, perirectal abscesses
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
- Anal crypts are mucosal pockets that lie between the columns of Morgagnia
Clinical Features
- Anal pain
- Sphincter spasm
- Itching with or without bleeding
- Hypertrophied papillae
Differential Diagnosis
Anorectal Disorders
- Anal fissure
- Anal fistula
- Anal malignancy
- Anal tags
- Anorectal abscess
- Coccydynia
- Colorectal malignancy
- Condyloma acuminata
- Constipation
- Crohn's disease
- Cryptitis
- GC/Chlamydia
- Fecal impaction
- Hemorrhoids
- Levator ani syndrome
- Pedunculated polyp
- Pilonidal cyst
- Proctalgia fugax
- Proctitis
- Pruritus ani
- Enterobius (pinworms)
- Rectal foreign body
- Rectal prolapse
- Syphilitic fissure
Non-GI Look-a-Likes
Evaluation
- Anoscopy shows inflammation, erythema, and pus
Management
- Bulk laxatives, additional roughage, sitz baths (treats underlying cause)
- Surgical referral is indicated when:
- Infection has progressed and the crypt will not drain adequately on its own
- Surgical treatment is excision