EXAMINATION

Although most patients requesting a proctologic examination have diagnosed themselves as having "hemorrhoids", a term which ,for most patients, pertains to any anal and/or rectal symptoms, the patient assessment is surely not enough to set a final diagnosis and is definitely not enough for setting a proper therapeutic course of action.

Only a careful examination of the disease history and of its symptoms, crosschecked with a competent examination of the anal and rectal region and with specific investigations may lead to an exact diagnostic, the crucial premise for setting a therapeutic course of action, capable of healing.

The proctologic examination represents the specialized examination of the anal duct and of the lower rectum, the fundamental condition for setting the exact diagnostic. It comprises several compulsory stages: inspection, palpation, digital examination, anuscopy, rectoscopy.

It is crucial that, considering the benign character of most anal and rectal region lesions, the symptoms reported by the patient should improve and disappear and, on the other hand, in the meanwhile, that other possible conditions, not necessarily related to anal pathology, should not be ignored so that the useful therapeutic moment should not be lost.

In common practice there are only several symptoms induced by anal pathology:

• bleeding;
• pain;
• tumor formation (tumefaction);
• secretions;
• itches;
• defecation-related symptoms.

These symptoms are encountered in various percentages in all anal conditions; most of them are the scope of business of our clinic: the haemorrhoidal disease and its complications, the anal fissure, haemorrhoidal polyps and pseudo-polyps, perianal abscesses and fistula, anal and perianal condyloma, perianal dermatitis and excoriations, etc.

However the same symptoms may be due to other disorders requiring a different therapeutic approach, usually under hospitalization; the precise diagnosis of such conditions is crucial in order to set the proper therapy: anal and rectal tumors albeit benign or malignant, colon tumors, inflammatory rectal and colon disorders (Crohn, rectocolita ulcerativa), rectocolitis, albeit viral, bacterial, parasitic, ischemic, medically-induced, post-irradiation, sexually transmitted disorders, vascular malformations, solitary rectal ulcer, traumas (enema, thermometers, sexual deviations), rectal prolapse, endometriosis, parasites, etc.

The proctologic examination represents the specialized examination of the anal duct and of the lower rectum, the fundamental condition for setting the exact diagnostic. It comprises several compulsory stages: inspection, palpation, digital examination, anuscopy, rectoscopy.