Cryptitis: Difference between revisions
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==Background== | ==Background== | ||
[[File:Gray1080.png|thumb|The interior of the anal cami and lower part of the rectum, showing the anal columns and the anal valves between their lower ends (columns in image numerous than typical).]] | [[File:Gray1080.png|thumb|The interior of the anal cami and lower part of the rectum, showing the anal columns and the anal valves between their lower ends (columns in image numerous than typical).]] | ||
[[File:Gray1078.png|thumb|Coronal section of rectum and the anal canal.]] | [[File:Gray1078.png|thumb|Coronal section of rectum and the anal canal.]] | ||
[[File:Rectum anatomy en.png|thumb|Anatomy of the anus and rectum.]] | [[File:Rectum anatomy en.png|thumb|Anatomy of the anus and rectum.]] | ||
*Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent [[diarrhea]], or passage of large/hard stools. | *Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent [[Special:MyLanguage/diarrhea|diarrhea]], or passage of large/hard stools. | ||
===Pathophysiology=== | ===Pathophysiology=== | ||
*Anal crypts are mucosal pockets that lie between the columns of Morgagni (i.e., anal columns) | *Anal crypts are mucosal pockets that lie between the columns of Morgagni (i.e., anal columns) | ||
**Anal columns are a number of vertical folds, produced by an infolding of the mucous membrane and some of the muscular tissue in the upper half of the lumen of the anal canal. | **Anal columns are a number of vertical folds, produced by an infolding of the mucous membrane and some of the muscular tissue in the upper half of the lumen of the anal canal. | ||
**Formed by the puckering action of the sphincter muscles | **Formed by the puckering action of the sphincter muscles | ||
*Superficial trauma ([[diarrhea]], trauma from hard stool) → breakdown in mucosal lining | *Superficial trauma ([[Special:MyLanguage/diarrhea|diarrhea]], trauma from hard stool) → breakdown in mucosal lining | ||
**Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands | **Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands | ||
***Can lead to [[anal fissure]], [[anal fistula]], [[perirectal abscesses]] | ***Can lead to [[Special:MyLanguage/anal fissure|anal fissure]], [[Special:MyLanguage/anal fistula|anal fistula]], [[Special:MyLanguage/perirectal abscesses|perirectal abscesses]] | ||
==Clinical Features== | ==Clinical Features== | ||
*Anal pain | *Anal pain | ||
*Sphincter spasm | *Sphincter spasm | ||
*Itching with or without bleeding | *Itching with or without bleeding | ||
*Hypertrophied papillae | *Hypertrophied papillae | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Anorectal DDX}} | {{Anorectal DDX}} | ||
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==Evaluation== | ==Evaluation== | ||
*Anoscopy shows inflammation, erythema, and pus | *Anoscopy shows inflammation, erythema, and pus | ||
==Management== | ==Management== | ||
#Bulk [[laxatives]], additional roughage, sitz baths (treats underlying cause) | |||
#Bulk [[Special:MyLanguage/laxatives|laxatives]], additional roughage, sitz baths (treats underlying cause) | |||
#Surgical referral is indicated when: | #Surgical referral is indicated when: | ||
#*Infection has progressed and the crypt will not drain adequately on its own | #*Infection has progressed and the crypt will not drain adequately on its own | ||
#*Surgical treatment is excision | #*Surgical treatment is excision | ||
==Disposition== | ==Disposition== | ||
*Outpatient | *Outpatient | ||
==See Also== | ==See Also== | ||
*[[Anorectal Disorders]] | |||
*[[Special:MyLanguage/Anorectal Disorders|Anorectal Disorders]] | |||
==External Links== | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:GI]] | [[Category:GI]] | ||
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Latest revision as of 21:59, 4 January 2026
Background
- Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent diarrhea, or passage of large/hard stools.
Pathophysiology
- Anal crypts are mucosal pockets that lie between the columns of Morgagni (i.e., anal columns)
- Anal columns are a number of vertical folds, produced by an infolding of the mucous membrane and some of the muscular tissue in the upper half of the lumen of the anal canal.
- Formed by the puckering action of the sphincter muscles
- Superficial trauma (diarrhea, trauma from hard stool) → breakdown in mucosal lining
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
- Can lead to anal fissure, anal fistula, perirectal abscesses
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
Clinical Features
- Anal pain
- Sphincter spasm
- Itching with or without bleeding
- Hypertrophied papillae
Differential Diagnosis
Anorectal Disorders
- Anal fissure
- Anal fistula
- Anal malignancy
- Anal tags
- Anorectal abscess
- Coccydynia
- Colorectal malignancy
- Condyloma acuminata
- Constipation
- Crohn's disease
- Cryptitis
- GC/Chlamydia
- Fecal impaction
- Hemorrhoids
- Levator ani syndrome
- Pedunculated polyp
- Pilonidal cyst
- Proctalgia fugax
- Proctitis
- Pruritus ani
- Enterobius (pinworms)
- Rectal foreign body
- Rectal prolapse
- Syphilitic fissure
Non-GI Look-a-Likes
Evaluation
- Anoscopy shows inflammation, erythema, and pus
Management
- Bulk laxatives, additional roughage, sitz baths (treats underlying cause)
- Surgical referral is indicated when:
- Infection has progressed and the crypt will not drain adequately on its own
- Surgical treatment is excision
Disposition
- Outpatient
See Also