Anorectal disorders

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
  • Internal hemorrhoid
  • External hemorrhoid
• 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

• Prostatitis

Algorithmic Diagnostic Approach

Pain and Bleeding

• External hemorrhoid
• Prolapsed internal hemorrhoid
• Anal Fissure
  • Off midline = cancer, HIV, TB, Crohn's

Pain and No Bleeding

• Swelling
  • Abscess
    • Perirectal
    • Ischiorectal
    • Intersphincteric
    • Supralevator
  • Pilonidal Cyst
  • Anal Fistula
  • Hidradenitis suppurativa
• No swelling
  • Proctalgia Fugax

Painless Bleeding

• Cancer
• Internal hemorrhoid

Painless Swelling

• Itch: Condyloma acuminata (warts secondary to HPV)
• No itch: Rectal prolapse

Itching

• Discharge: Proctitis
• No discharge: Pruritus Ani

See Also

• Diagnoses by Body Part (Main)