Anorectal disease: how to relieve pain and improve other symptoms.

Anorectal diseases such as hemorrhoids, anal fissures, and anorectal abscesses are common in older patients. These conditions-along with and incontinence, rectal prolapse, and pruritus ani-cause considerable suffering and morbidity. The key to diagnosis remains the patient history, with confirmation by visual inspection and anoscopy. Expensive workups are usually not required. Most anorectal diseases can be easily treated in the outpatient setting with dietary changes and/or relatively minor procedures. Patients with more severe disease may require referral for surgery. Although uncommon, carcinomas do occur in the anorectal area, and lesions that cannot be identified by inspection should be biopsied.