Cryptitis

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

Clinical Features

  • Anal pain
  • Sphincter spasm
  • Itching with or without bleeding
  • Hypertrophied papillae

Differential Diagnosis

Anorectal Disorders

Evaluation

  • Anoscopy shows inflammation, erythema, and pus

Management

  1. Bulk laxatives, additional roughage, sitz baths (treats underlying cause)
  2. Surgical referral is indicated when:
    • Infection has progressed and the crypt will not drain adequately on its own
    • Surgical treatment is excision

See Also

References