Benign anal conditions: haemorrhoids, fissures, perianal abscess, fistula-in-ano and pilonidal sinus

Benign perianal conditions represent a significant workload for the general surgeon and colorectal specialist. Patients present with a variety of symptoms, some of which may be difficult to distinguish from a more sinister cause without a careful history, examination and investigation. This article discusses the basic aetiology, clinical features and current evidence-based treatment recommendations for each of the conditions of haemorrhoids, fissures, perianal abscess, fistula-in-ano and pilonidal sinus. (Ischiorectal abscess is not addressed.)