GP Q&A
How would explain significant nocturia when lying down to point of flooding especially if deep asleep but then she wakes up because of this. She has pelvic floor dysfunction , obesity diabetes and and uncontrolled OSA and OA of lumbar spine and possible Ehler Danlos syndrome She has seen pelvic floor physio who suggested use [...]
Do you recommend any websites or you tube videos , which we can recommend to patients for pelvic floor exercises? Allison Bryant: Firstly, I would say that it is important to make sure that the patient does need to do strengthening of the pelvic floor. Many patients we see have a stiff, tight pelvic floor [...]
For people with recurrent anal fissures, can they purely be due to tight anal sphincter (when other possible causes excluded clinically)? Dr Chris Gillespie: Yes – one of the most common causes of anal fissures is anal hypertonia. Treatment to reduce anal pressures leads to healing (eg. Rectogesic/Botox/sphincterotomy)
Differentiation of acutely inflamed external haemorrhoids for rectal prolapse. Chris Gillespie: Differentiation is usually on clinical exam. Rectal prolapse has transverse folds, and on palpation feels like the full thickness of the rectal wall. External haemorrhoids are mucosal thickness only. Often best examined on the commode/toilet after straining.
Is perianal haematoma the same as small external haemorrhoids? Chris Gillespie: The nomenclature here is confusing. “Perianal haematoma” is a small localised haematoma in the perianal skin, walled off by fibrous bands to the dermis. “External haemorrhoid” usually refers to a prolapsed haemorrhoid (arising from internal), although some textbooks use external haemorrhoid to refer to [...]
