History
Aspects of the history can help to differentiate between the various anorectal pathologies (Table 1).
With external haemorrhoids or rectal prolapse, other symptoms include:
- Itch
- Discharge
- Swelling
|
Pain |
Bleeding |
|
|---|---|---|
| Haemorrhoids | Normally painless, unless thrombosed [3] | Tend to cause bright red blood on stool or pan [1-2] |
| Anal fissure | Severe pain on defecation lasting for 1-2 hours after [5] | Small amount of bright red blood on paper [1-2] |
| Anorectal abscess | Pain worse on defecation or sitting; a tender swelling; deep pain or buttock pain depending on location of abscess [1] | Small amounts of blood or pus per rectum (PR) may occur if fistula is present |
| Rectal prolapse | Normally painless, unless strangulated | Blood-stained mucus PR [4] |