Bassford T
Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson.
Am Fam Physician. 1992 Apr;45(4):1787-94.
Family physicians can manage most common anorectal disorders seen in office practice. Proctitis is usually caused by sexually transmitted infections that can be treated with antibiotics. Pruritus ani, anal fissures, fungal infections and hygiene problems are all amenable to simple treatments. Thrombosed external hemorrhoids can be opened and drained. Bleeding or symptomatic internal hemorrhoids can be treated with rubber-band ligation. Perirectal or ischiorectal abscesses require incision and drainage, sometimes under general anesthesia. Serious disorders such as inflammatory bowel disease and cutaneous malignancies should always be considered in the differential diagnosis of common anorectal disorders.
家庭医生可以处理门诊中常见的大多数肛肠疾病。直肠炎通常由性传播感染引起，可用抗生素治疗。肛门瘙痒、肛裂、真菌感染和卫生问题都适合进行简单治疗。血栓性外痔可以切开引流。出血性或有症状的内痔可用橡皮圈套扎术治疗。直肠周围或坐骨直肠窝脓肿需要切开引流，有时需要在全身麻醉下进行。在常见肛肠疾病的鉴别诊断中，应始终考虑炎症性肠病和皮肤恶性肿瘤等严重疾病。
