Perianal Symptom Assessment

Perianal Symptom Assessment

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Perianal Symptom Assessment Patricia Carruthers-Czyzewski, BScPhm, MSc Date of Revision: March 2013

Assessment Algorithm

1,2,3,4,5

Figure 1: Assessment of Patients with Perianal Symptoms

a b

See Pinworms. See Hemorrhoids.

Patients may erroneously attribute any perianal symptom to hemorrhoids. In fact these symptoms may be due to a number of conditions, ranging in severity from poor hygiene to colorectal cancer. An assessment plan for patients reporting perianal symptoms is illustrated in Figure 1. All too often, patients seeking relief with nonprescription agents have delayed consulting a pharmacist or physician until the symptoms have become unbearable and the condition has advanced to the point where medical referral is necessary. 6,7

Table 1: Risk Factors for Colorectal Cancer Age >50 years

History of colorectal cancer or adenomatous polyposis

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Perianal Symptom Assessment

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Family history of familial adenomatous polyposis or hereditary nonpolyposis colon cancer Inflammatory bowel disease

Strong family history (either cancer or polyps in a first-degree relative <60 years old or 2 first-degree relatives of any age)

References 1. Turnbull GK, Vanner SJ, Burnstein M et al. The colon. In: Thomson AB, Shaffer EA, eds. First principles of gastroenterology: the basis of disease and an approach to management. 5th ed. Toronto: Janssen-Ortho; 2005. 2. Zuber TJ. Diseases of the rectum and anus. In: Taylor RB, ed. Family medicine: principles and practice. 6th ed. New York: Springer; 2003. p. 776-83. 3. Pfenniger JL, Zainea GG. Common anorectal conditions: Part I. Symptoms and complaints. Am Fam Physician 2001;63:2391-8. 4. Pfenniger JL, Zainea GG. Common anorectal conditions: Part II. Lesions. Am Fam Physician 2001;64:77-88. 5. Schubert MC, Sridhar S, Schade RR et al. What every gastroenterologist needs to know about common anorectal disorders. World J Gastroenterol 2009;15:3201-9. 6. American Cancer Society. Colorectal cancer. Early detection, diagnosis, and staging topics. Can colorectal polyps and cancer be found early? Available from: www.cancer.org/docroot/CRI/content /CRI_2_4_3x_Can_Colon_and_rectum_cancer_be_found_early.asp. Accessed January 14, 2013. 7. Canadian Cancer Society. Colorectal cancer. Available from: www.cancer.ca/en/cancer-information/cancertype/colorectal/colorectal-cancer/. Accessed November 13, 2014. CPhA assumes no responsibility for or liability in connection with the use of this information. For clinical use only and not intended for for use by patients. Once printed there is no quarantee the information is up-to-date. [Printed on: 03-03-2016 02:13 PM] RxTx, Compendium of Therapeutics for Minor Ailments © Canadian Pharmacists Association, 2016. All rights reserved

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