Last reviewed:December 2019
Last updated:January  2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • rectal bleeding
  • perianal pain/discomfort

Other diagnostic factors

  • anal pruritus
  • tender palpable perianal lesion
  • anal mass

Risk factors

  • age between 45-65 years
  • constipation
  • pregnancy or space-occupying pelvic lesion
  • hepatic insufficiency
  • ascites

Diagnostic investigations

Treatment algorithm

Contributors

Senior Lecturer and Consultant in Colorectal Surgery

National Bowel Research Centre (NBRC)

Blizard Institute

Barts and The London School of Medicine & Dentistry

Queen Mary University of London

London

UK

Disclosures

MAT held a clinical research training fellowship (2000-2003) and has obtained research grants (2000-2006) from Ethicon Endo-Surgery (UK and Europe).

Senior Fellow in Colorectal Surgery

Colorectal Surgery & Pelvic Floor Services

Royal London Hospital

Barts Health NHS Trust

London

UK

Disclosures

JDJ declares that he has no competing interests.

Professor of Surgery

Ninewells Hospital & Medical School

University of Dundee

Dundee

UK

Disclosures

RJCS declares that he has no competing interests.

Dr Mohamed A. Thaha and Professor Robert J.C. Steele would like to gratefully acknowledge Dr Kurt G. Davis, the previous contributor to this topic.

Peer reviewersVIEW ALL

Honorary Clinical Research Fellow

Division of Surgery

Oncology

Reproductive Biology and Anaesthetics

Imperial College

St Mary's Hospital

London

UK

Disclosures

GR declares that he has no competing interests.

Clinical Research Fellow

Department of Biosurgery and Surgical Technology

Imperial College

St Mary's Hospital

London

UK

Disclosures

AVR declares that he has no competing interests.

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