Anorectal conditions

Colorectal and General Surgeon Parry Singh discusses common anorectal conditions, including the history, examination and management of haemorrhoids, perianal hematoma, and anal fissures.

Topics

Intro
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haemorrhoids and patient history
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Assessing haemorrhoids - physical examination
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Grading system for haemorrhoids
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Management of haemorrhoids
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Topical treatment of haemorrhoids
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Indicators for referral
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What to expect when you see a specialist
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Colorectal cancer in at risk populations
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Perianal haematoma - How do we diagnose?
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Anal fissure diagnosis
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Anal fissure are difficult to manage
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Take-home messages
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Take home messages

Haemorrhoids are a spectrum of disease and can be present concurrently with other pathology
Painful rectal bleeding is most commonly an anal fissure
Advice on diet and toileting behaviour an important aspect in long-term management
Rectal bleeding with red flag symptoms or a concerning examination warrants referral
Extra vigilance is warranted for at-risk populations

Resources

Choice of treatment for haemorrhoids NZDoctor
Haemorrhoids | Mate tero puta Healthify - He Puna waiora
Key points about anal fissures Healthify - He Puna waiora
Referral of patients with features suggestive of bowel cancer bpacnz - better medicine

Presenter

Parry Singh

Colorectal and General Surgeon

Parry is a Colorectal and General Surgeon who practices at Middlemore Hospital and the Auckland Colorectal Centre. He completed his medical degree and specialist surgical training in New Zealand with a further overseas subspecialty fellowship in colorectal surgery through the Colorectal Surgical Society of Australia and New Zealand (CSSANZ).

Through this experience, Parry has gained expertise in managing the wide array of colorectal conditions, ranging from complex problems related to colorectal cancer, inflammatory bowel disease and diverticular disease; to the more common and troubling anorectal conditions such as haemorrhoids, anal fistulas, and anal fissures. This comes with experience in a range of advanced surgical procedures including minimal invasive techniques such as laparoscopy, as well as being accredited to perform colonoscopy and removal of polyps.