Findings on anal inspection

Pruritus ani, perianal warts, perianal abscess, perianal haematoma, prolapsing haemorrhoids, thrombosed haemorrhoids, skin tags, anal discharge, anal fistulas, anal fissures, anal cancer, rectocele, rectal prolapse, threadworms, faecal soiling of the perineum are all possible findings (Rhodes & Hsin, 1995; Barkauskas, 2002).

The anal tone can be observed at rest and on voluntary contraction. The patient should be asked to strain down as if opening bowels to show perianal descent, prolapsing haemorrhoids or protruding lesions such as tumours or rectal prolapse (Barkauskas, 2002).

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