Benign anorectal conditions

Benign anorectal conditions relate to a collection of common pathologies with varied presentations. These conditions make up a significant proportion of patients seen on the general surgical on-call and are frequently referred to colorectal outpatient clinics via the 'two-week wait' pathway. Benign disorders can occur concomitantly with colorectal carcinoma and the clinician should be wary in ascribing the patients' symptoms to the presence of benign pathology only. Certain disorders, such as rectal prolapse, have a devastating impact on the patients' quality of life; however, accurate diagnosis and appropriate management strategies, including setting patient expectations and a multi-disciplinary approach where appropriate, can improve patient outcomes. This article is a summary of common benign anorectal conditions; abscesses, fistula-in-ano, pilonidal disease, anal fissure, haemorrhoids, rectal prolapse and anorectal syndromes; pain, pruritus ani, obstructive defaecation syndrome and faecal incontinence. The definition, epidemiology and aetiology of these conditions will be considered along with salient points in the clinical assessment and management.