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decrease in stool frequency, with difficulty passing of very hard, dry stool


painful longitudinal tear in tissue (in the superficial mucosa at the anal margin)


painless, flabby papules of skin or mucous membrane in the anal region caused by a varicose vein of the hemorrhoidal plexus and increased portal venous pressure. When thromboses, it contains clotted blood and becomes a painful, swollen shiny blue mass that itched and bleeds with defecation.


blood in stool

Pruritus Ani

itching or burning sensation in skin. red, raised, thickened, excoriated skin around the anus. Common causes are pinworms in children and fungal infections in adults. The area is swollen and moist, and with a fungal infection, it appears dull grayish pink. The skin is dry and brittle with psychosomatic itching.


excessive fat in the stool as in gastrointestinal malabsorption of fat

Valves of Houston

set of three semilunar transverse folds that cross one-half the circumference of the rectal lumen

pilonidal Cyst or Sinus

a hair containing cyst or sinus located in the midline over the coccyx or lower sacrum. Often open as a dimple with visible tuft of hair and possible an erythematous halo. Or may appear a a palpable cyst. When advanced, has a palpable sinus tract. Although it is a congenital disorder, the lesion is first diagnosed between age 15-30

Anorectal fistula

a chronically inflamed gastrointestinal tract creates an abnormal passage from the inner anus or rectum out to the skin surrounding anus. Usually originates from local abscess. The red raised tract opening may drain serosanguineous or purulent matter when pressure applied

Rectal Prolapse

the rectal mucous membrane protrudes through the anus, appearing as a moist red donut with radiating lines. When prolapse is incomplete, only the mucosa bulges. When complete, it includes the anal sphincters. Occurs following a Valsalva maneuver, such as staining at stool or with exercise


A localized cavity of pus form infection in a pararectal space. Infection usually extends from an anal crypt. Characterized by persistent throbbing rectal pain. Appears red, hot, swollen, indurated, and tender.

Rectal polyp

a protruding growth from the rectal mucous membrane the is fairly common. The polyp may be pedunculated (on a stalk) or sessile (a mound on the surface, close to the mucosal wall). Biopsy needed to remove


S: frequency, nocturia, hematuria, weak stream, hesitancy pain or burning on urinating. Continuous pain in lower back, pelvis, and thighs
O: a malignant neoplasm in the rectum is asymptomatic; thus the importance of routine rectal palpation. An early lesion may be a single firm nodule with irregular cauliflower shape and is fixed and stone hard.

Benign Prostatic Hypertrophy (BPH)

S: urinary frequency, urgency, hesitancy, straining to urinate, weak stream, nocturia
O: a symmetric nontender enlargement, commonly occurs in males beginning in the middle years. the prostate surface feels smooth, rubbery, or firm, with median sulcus obliterated


S: fever, chills, malaise, urinary frequency and urgency, Dysuria, urethral discharge, dull aching pain in perineal and rectal area.
O: An exquisitely tender enlargement is acute inflammation of the prostate gland yielding a swollen slightly asymmetric gland that is quite tender to palpate

Prostate gland

secretes a thin, milky, alkaline fluid that helps with viability of sperm

Seminal Vesicles

secretes fluid rich in fructose, which nourishes the sperm and contains prostaglandin's

Bulbourethral glands

secrete clear viscid mucus

Bengin prostatic hypertrophy

prostate grows larger with age, caused by hormonal imbalance and restricts urine output


pain due to a local condition (hemorrhoid, fissure) or constipation


itching, pain, or burning


persistent passing of stool in clothing in a child older than 4

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