True/False MCQ · Anorectal Disorders
Regarding anal fissures, the following statements are TRUE:
- AThey cause severe pain during and after defecation
- BThey are most commonly located in the posterior midline (6 o'clock)
- CProctoscopy should always be performed in a conscious patient with an acute fissure
- DThere is a strong association with constipation
- EMultiple fissures should raise the suspicion of Crohn's disease
Show answers and explanation
- A. True
- B. True
- C. False: Proctoscopy (and DRE) is exceedingly painful in an acute fissure and should be avoided in a conscious patient; the diagnosis is made by inspection.
- D. True
- E. True
Anal fissures
Anal fissures are painful splits in the lower anal canal.
Key facts
- Cause severe pain during and after defecation with internal sphincter spasm.
- Most are in the posterior midline (6 o'clock).
- Strong association with constipation.
- Multiple fissures suggest Crohn's disease.
The error
- Proctoscopy/DRE is too painful in an acute fissure and should be avoided in a conscious patient; the diagnosis is made by inspection.
Statement-by-statement verdict
Why A is true
They cause severe pain during and after defecation.
Why B is true
They are most commonly in the posterior midline.
Why C is false
Proctoscopy is too painful in an acute fissure and should be avoided in a conscious patient.
Why D is true
There is a strong association with constipation.
Why E is true
Multiple fissures suggest Crohn's disease.
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