Problems and prevention in proctology

Pathology in the lower rectum, anal canal and perineum is common and causes much distress. It tends to be self-diagnosed and treated. Eventually a physician is consulted and the usual diagnosis proposed by the patient is "It's my hemorrhoids". However, this may conceal a considerable spectrum of pathology. Diagnosis is usually not difficult but the treatment may not always be so straightforward. This paper discusses hemorrhoids, fissure-in-ano, abscesses, anal fistulae, condylomata and pruritus ani. High risk groups for carcinoma of the colon and rectum are identified. Hemoccult® testing should be instituted at the annual physical examination for both of these conditions.