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Pictures of skin tags on anus or rectum11/9/2023 Proctologic assessment was performed in the knee-chest position by inspection of the anal verge followed by digital examination of the anal canal, and anoscopy. Individuals were asked to complete a questionnaire that described their symptoms and signs (table 1). We investigated the types and frequencies of anal complaints with respect to anal findings at proctologic assessment using the knee-chest position in contrast to the widely used left lateral Sims' position to evaluate its pros and cons. The sensitivity, specificity and predictive value of patients' positioning in diagnosis of BAD, concomitant anal findings (CAF), and multiple anal lesions (MAL) with one individual also remain unknown. left-lateral, knee-chest, lithotomy or the upright standing-bented) is the most reliable for determining the causes of anal bleeding, anal itch, anal pain or anal burning. It is also unknown which examination position (i.e. History taking does not lead to accurate anal diagnoses. The German National Insurance Fund spends 38 million Euros yearly for ointments and suppositories whose use is not supported by any scientific data. The cost of treating benign anal diseases (BAD) in the United States exceeds 2 billion dollars annually. In the US about 1.5 million prescriptions for anorectal preparations are written yearly. The exact incidence of haemorrhoids is unknown as estimates vary. "Haemorrhoids and their symptoms are one of the most common afflictions in the western world". This practice still prevails: "Almost everyone suffers from haemorrhoids at some time in their lives". Lockhart-Mummery once wrote "nearly every lesion around the anus is liable to be called 'piles' by the patient and not infrequently by the referring doctor also". Patients suffering from any symptoms related to the anus frequently and often incorrectly assume that their symptoms are due to haemorrhoids. Keywords: haemorrhoids, pruritus ani, fissure-in-ano, thrombosed external haemorrhoid, benign anorectal diseases, Sims' position, knee-chest-position Introduction Anal lesions could be predicted according to patients' answers in the questionnaire: haemorrhoids by anal bleeding (p=0.032), weeping (p=0.017), and non-existence of anal pain (p=0.005) anal fissures by anal pain (p=0.001) and anal bleeding (p=0.006) pruritus ani by anal pain (p=0.001), itching (p=0.001), and soreness (p=0.006).Ĭonclusions: The knee-chest position may allow for the accumulation of more detailed information about BAD than the left lateral Sims' position, thus enabling physicians to make more reliable anal diagnoses and provide better differentiated therapies. The distribution of stages in 317 pruritus ani patients was: mild (91), moderate (178), severe (29), and chronic (19). After haemorrhoids (401 patients), pruritus ani (317 patients) was the second most frequently found BAD. Concomitant anal findings such as skin tags were more frequently seen in patients with than without BAD (<0.01). Almost one third (31.2%) of patients with BAD had more than one BAD. ![]() ![]() Results: Eight hundred seven individuals, 539 (66.8%) with and 268 without BAD were analysed. Findings were entered into a PC immediately after the assessment of each individual. Definitions of BAD were tested in a two year pilot study. Proctologic assessment was performed in the knee-chest position. Methods: Patients transferred from GPs, physicians or gynaecologists for anal and/or abdominal complaints/signs were enrolled and asked to complete a questionnaire about their symptoms. File import instruction Abstractīackground: The frequencies and types of anal symptoms were compared with the frequencies and types of benign anal diseases (BAD). Select the file that you have just downloaded and select import option Reference Manager (RIS). Relationship between anal symptoms and anal findings. Kuehn HG, Gebbensleben O, Hilger Y, Rohde H.
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