Editorial
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 14, 2009; 15(26): 3201-3209
Published online Jul 14, 2009. doi: 10.3748/wjg.15.3201
What every gastroenterologist needs to know about common anorectal disorders
Moonkyung Cho Schubert, Subbaramiah Sridhar, Robert R Schade, Steven D Wexner
Moonkyung Cho Schubert, Subbaramiah Sridhar, Robert R Schade, Department of Gastroenterology and Hepatology, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, United States
Steven D Wexner, Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, United States
Author contributions: Schubert MC and Wexner SD contributed equally to this work; Schubert MC, Schade RR, and Sridhar S designed the paper; Wexner SD edited the manuscript and contributed figures; Schubert MC wrote the paper and contributed tables.
Correspondence to: Moonkyung Cho Schubert, MD, PhD, Gastroenterology and Hepatology Medicine, Medical College of Georgia, 1120 15 St. BBR2536, Augusta, GA 30912, United States. chomoonkyung@yahoo.com
Telephone: +1-706-7212238
Fax: +1-706-7210331
Received: February 24, 2009
Revised: June 9, 2009
Accepted: June 16, 2009
Published online: July 14, 2009
Abstract

Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders. Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting, but patients tend not to seek medical attention due to embarrassment or fear of cancer. As a result, patients frequently present with advanced disease after experiencing significant decreases in quality of life. A number of patients with anorectal complaints are referred to gastroenterologists. However, gastroenterologists’ knowledge and experience in approaching these conditions may not be sufficient. This article can serve as a guide to gastroenterologists to recognize, evaluate, and manage medically or non-surgically common benign anorectal disorders, and to identify when surgical referrals are most prudent. A review of the current literature is performed to evaluate comprehensive clinical pearls and management guidelines for each topic. Topics reviewed include hemorrhoids, anal fissures, anorectal fistulas and abscesses, and pruritus ani.

Keywords: Anal fissures, Anorectal disease, Anorectal fistulas and abscesses, Hemorrhoids, Pruritus ani