John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Good reflexes in proctology: Knowing how to listen and watch to treat well Volume 28, issue 8, Octobre 2021


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Clinique Saint-Antoine, Groupe Kantys, 7 avenue Durante, 06000 Nice
* Correspondance

Proctology is frequent in gastroenterology consultation, reported up to 20% of cases. It is also frequent in general practice with sometimes an erroneous diagnosis because of a lack of knowledge or physical examination. The most frequent diagnoses are hemorrhoidal disease, anal fissure, anal infections and sexually transmitted infections. The symptoms are pain, a tumefaction, itching and bleeding. From these elements which will have to be specified during the interview, a diagnosis will be evoked and most often confirmed by the physical examination. More rarely, complementary procedures will be necessary. It is important to take time to listen, to review important points as anal surgery, obstetric injuries, inflammatory bowel disease. A transit disorder, the age of the symptoms, their recurrent characteristic, the date of the beginning, treatments tried, must be specified. It is important to examine in good conditions, in knees to chest or left lateral side position, with a sufficient powerful quality lighting, a water-based lubricant, a local anesthetic (for example, lidocaine hydrochloride 2% jelly or pramoxine hydrochloride 1% jelly) and different sizes of proctoscope. The following clinical cases are there to remind you how much the semiology is important in the management of proctological diseases.