![]() For example, painful conditions, particularly with an acute onset, often affect the highly sensitive anoderm, and a diagnosis of anal fissure is likely if pain first occurs after defecation and has an intense and sharp quality. ![]() Many proctologic diseases show typical clinical findings that can be noted when the patient’s history is being taken and make it much easier to establish the diagnosis. Taking a detailed proctologic history is essential for establishing a trusting physician–patient relationship, and it is also the most important pillar of diagnosis. Additional examinations are reserved for specific problems and are discussed along with the relevant clinical pictures ( Fig. The latter includes a digital rectal examination and proctoscopy/rectoscopy. This first section explains the basic techniques used in a proctologic examination, which - as in any type of clinical picture - provide the basis for successful subsequent treatment.īasic proctologic diagnosis includes taking a detailed patient history, followed by clinical and machine-aided diagnostic work-up. The aim of this series of articles on proctology is to provide the necessary proctologic information, although limited to the most frequent disease pictures. However, relevant findings often remain hidden in routine flexible endoscopy examinations, as they can only be adequately assessed using rigid endoscopy. ![]() Many proctologic findings may be noted incidentally during routine colonoscopy. However, the diagnosis of proctologic diseases is relevant to all physicians working in endoscopy, who therefore need to ensure that they have the relevant basic knowledge and are able to confidently assess the most frequent clinical pictures. ![]() As a therapeutic discipline, proctology belongs primarily to the field of visceral surgery. ![]()
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