Discomfort in the anal region What can it be? What can you do?

52 Pages·2009·4.09 MB·English

The informed patient
Discomfort in
the anal region
What can it be?
What can you do?
Revised
edition 2009
Publisher
www.drfalkpharma.com
©2009Dr. Falk Pharma GmbH
Allrightsreserved. 8threvisededition2009
The informed patient
Discomfort in
the anal region
What can it be?
What can you do?
Priv. Doz. Dr. Wilhelm Brühl
Author:
Priv.Doz.Dr.W.Brühl
Wissenschaftliches
InstitutfürProktologie
32068BadSalzuflen-
Vlotho/Exter
Germany
DarmzentrumExter
DetmolderStr.264
32602Vlotho/Exter
Germany
Tel.[phone]
http://www.darmzentrum-exter.de
Foreword Manypersonssufferfromvarious
complaintsinvolvingtheanalregion.
Inmanycases,hemorrhoidsarere-
sponsible.Theseareoftentreated
withointments,suppositories,sitz
bathsandvarioushomeremedies
but,asmanysufferershavealready
learned,theresultsarenotalways
satisfactoryormayonlybetempo-
rary.
Onereasonforthisexperienceis
thatpatients’complaintsarenot
alwaysduetohemorrhoids.Avariety
ofotherdisorderscanaffecttheanal
region.Evenmalignanttumorsmay
beinvolved:Hence,oneshouldnot
carelesslyoverlookthem.
Thisbrochureisintendedtohelp
youidentifythedisorderbehindyour
complaintsandprovideguidance
onwhatshouldbedone.While
helpingyourecognizeimportant
signs,itshouldreducefearwhere
thisisunwarranted.Itisessential
thatyouconsultyourphysicianand
describeyoursymptomsasexactly
aspossible.
Digestive organs
1
2 2
5 3
4
6 7
8
(cid:1)Esophagus
(cid:2)Diaphragm
9
(cid:3)Liver
(cid:4)Gallbladder
(cid:5)Stomach
(cid:6)Smallbowel
(cid:7)Colon
(cid:8)Rectum
(cid:9)Anus
44
Anatomyoftherectumandanus 6
Symptoms Causes
Bleeding Hemorrhoids 8
Colonpolyps 10
Coloncancer 12
Colitis 14
Lesscommoncauses:
Analeczema,analfissure,
analwallthromboses.
Pain Periproctalabscess 16
Analfissure 18
Proctalgiafugax 20
Coccygodynia 22
Cryptitis 24
Lesscommoncauses:
Prolapsinghemorrhoids,
irritablebowelsyndrome,
analwallthromboses.
Spotting Sphincterweakness 26
Perianalfistula 28
Lesscommoncauses:
Analeczema,hemorrhoids.
Itching Analeczema 30
Lesscommoncauses:
Condylomata.
Nodeformation Marisques 32
Condylomata 34
Analwallthromboses 36
Rectalprolapse 38
Lesscommoncauses:
Prolapsinghemorrhoids.
Stoolchanges Irritablebowelsyndrome 40
Diverticulardisease 42
Crohn’sdisease 44
Lesscommoncauses:
Coloncancer,colitis
colonpolyps.
Appendix Theimportanceof 46
well-formedstool
Anatomy
of the rectum and anus
1
7
3 3
5
4
6
2
8 8
6
Thefinalsegmentofthegastroin-
testinaltractiscalledtherectum(cid:1).
Therectumendsintheanus(cid:2),a
shortcanalformedbyaninternal(cid:3)
andexternalsphincter(cid:4),bothof
whicharemuscularrings.Between
themaremanyanalglands(cid:8).The
boundarybetweentherectumand
anusismarkedbyalinecalledthe
lineadentata,whichisformedby
arowofalternatingswallow’snest-
likedepressions(analcrypts,(cid:6))
andtooth-likeprotuberances(anal
papillae(cid:5)).Thislinedividesthe
highlysensitiveandsometimesvery
(cid:1)Rectum painfulanalregionfromtherectum,
(cid:2)Anus whichisquiteinsensitivetopain.
(cid:3)Internalsphincter Abovethislineisalsothecircular
(cid:4)Externalsphincter formationofthehemorrhoidal
(cid:5)Analpapillae cushion(cid:7).
(cid:6)Analcrypts
(cid:7)Hemorrhoidalcushion
(cid:8)Analglands
7
Hemorrhoids
1 2
3
8