Anal and perianal disorders

Most anal diseases can be diagnosed by a careful history and examination.Management of haemorrhoids involves exclusion of more serious pathology, adequate explanation of the disorder, and dietary and defecatory advice. Most haemorrhoids do not require additional treatment. Outpatient procedures or surgical intervention may be required for more symptomatic cases.Anal fissures are initially managed with bulking laxatives and non-constipating analgesics. Glyceryl trinitrate ointment is standard first-line treatment.