Symptoms associated with [[rectal cancer]], [[anal fissure]], [[anal abscess]], [[anal fistula]], and other diseases may be similar to those produced by hemorrhoids and may be reduced by the topical analgesic methods described above. For this reason, it is a good idea to consult with a physician when these symptoms are encountered, particularly for the first time, and periodically should the problem continue.
Hemorrhoids should be differentiated from other diseases causing anal discomfort and pain with defaecation such as [[rectal cancer]], [[anal fissure]], [[anal abscess]], [[anal fistula]].
==Differentiating Hemorrhoids from other Diseases==
==Differentiating Hemorrhoids from other Diseases==
Line 10:
Line 10:
Hemorrhoids should be differentiated from other diseases causing anal discomfort and pain with defaecation.
Hemorrhoids should be differentiated from other diseases causing anal discomfort and pain with defaecation.
Hemorrhoids should be differentiated from other diseases causing anal discomfort and pain with defaecation.
Disease
History
Physical exam findings
Sample image
Anal fissure
Anal fissure usually presents with tearing pain with every bowel movement.
Pain usually lasts for minutes to hours after every bowel movements.
Patient is typically afraid of going to the bathroom to avoid the pain, which leads to a viscious cycle. The fissure worsens the constipation and the constipation (hard stool) aggravates the fissure.
About two thirds of the patients present with bright red blood streaks on toilet papers or on the surface of stools.
May be accompanied by pruritis and discharge.
Most fissures occur in the posterior midline of the anal canal.
Skin tags in the perianal area may accompany chronic anal fissures.
Anal fissure - Own work, Public Domain, httpscommons.wikimedia.orgwindex.phpcurid=8885750
Rectal prolapse most commonly occurs in multiparous females over 40 years old.
Progressive mass protrusion from the anus. Protrusion at first with straining and defecation then progresses to the degree that it is no longer be replaced.
It presents with abdominal discomfort and incomplete defecation.
Fecal incontinence and anal discharge.
Pain is not usually present.
Mass protruding from the anus.
Concentric mucosal rings are characteristic for rectal prolapse.
Rectal prolapse - By Dr. K.-H. Günther, Klinikum Main Spessart, Lohr am Main - Dr. K.-H. Günther, Klinikum Main Spessart, Lohr am Main, CC BY 3.0, httpscommons.wikimedia.orgwindex.phpcurid=20649968
Patient may give a history of anal condyloma (especially homosexual men).
Fecal incontinence.
On digital rectal examination, solid hemorrhagic mass that is firmly fixed to the surrounding structures is noted.
Femoral and inguinal lymph nodes may show lymphadenopathy secondary to spread of cancer.
Anal Cancer - By Internet Archive Book Images - httpswww.flickr.comphotosinternetarchivebookimages14598073128Source book page httpsarchive.orgstreamdiseasesofrectum00gantdiseasesofrectum00gant-pagen653mode1up, No restrictions, httpsc
