Cryptitis

Background

Anatomy of the anus and rectum.
  • 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 Morgagnia
    • Formed by the puckering action of the sphincter muscles
  • Superficial trauma (diarrhea, trauma from hard stool) → breakdown in mucosal lining

Clinical Features

  • Anal pain
  • Sphincter spasm
  • Itching with or without bleeding
  • Hypertrophied papillae

Differential Diagnosis

Anorectal Disorders

Evaluation

  • Anoscopy shows inflammation, erythema, and pus

Management

  1. Bulk laxatives, additional roughage, sitz baths (treats underlying cause)
  2. Surgical referral is indicated when:
    • Infection has progressed and the crypt will not drain adequately on its own
    • Surgical treatment is excision

Disposition

See Also

References