Jarvis Chapter 25- Anus, Rectum, Prostate

Jarvis Chapter 25- Anus, Rectum, Prostate

1. Key Terms

   • BPH (benign prostatic hypertrophy): enlarged prostate common in males older than 40yrs
   • dyschezia: pain due to local condition such as hemorrhoid or fissure
   • Melena: black stools due to blood in the stool from GI bleed
   • Steatorrhea: excessive fat in the stool from malabsorption (in celiacs or cystic fibrosis, pancreatitis, crohns)
   • Polyp: soft, slightly movable mass

2. During Exam

   • use appropriate lubricant
     • wear gloves
       • approach the anus from a sliding angle, never a 90 degree angle which would involve jabbing

3. Abnormal Findings of Anal Region

   • Pilonidal Cyst or Sinus
     • hair containing cyst located in the midline overcoccyx and sacrum
     • Congenital, diagnosed between age 15-30
   • Anorectal Fistula
     • caused from a chronically inflammed GI tract, an abnormal passage is created from inner anus or rectum to skin surrounding anus
     • with Crohns disease
   • Fissure
     • painful longitudal tear in superficial mucosa at the anal margin
     • described as "passing shards of glass", may have bright red blood in stool
   • Hemorrhoids
     • external or internal, protruding vein
     • when painful, it is due to thrombosed hemorrhoid where it contains clotted blood and swells, looks shiny blue, and becoming painful and itchy
   • Rectal Prolapse
     • looks like a red moist donut with radiating lines
     • complete rectal mucous membrane protrudes through the anus
   • Pruritus Ani
     • intense itching
       • from pinworm infection, prolapsed hemorrhoid, anal fissure, IBS, chronic diarrhea
     • red, raised, irritated skin

4. Abnormal Findings of Rectum

   • Abscess
     • localized cavity of pus from infection
     • should be drained and treated to prevent sepsis or further pain
   • Rectal Polyp
     • protruding growth from rectal mucous membrane
     • common but need to be biopsied to screen for malignancy
   • Fecal Impaction
     • colon blockage by hard, immovable stool
   • Carcinoma
     • malignant neoplasm, asymptomatic, can be palpable

5. Abnormal Findings of Prostate

   • BPH (Benign Prostatic Hypertrophy)
     • enlarged prostate,disturbs urinary system
   • Prostatitis
     • inflammation, tenderness, causes fever, fatigue, urinary frequency and urgency
   • Carcinoma
     • malignant neoplasm, starts as single, hard nodule and changes, disturbs urinary system and pain in lower back, thighs, pelvis

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