The Prevalence of Anorectal Disorders among Residents of Kirtipur Municipality in Nepal

Background: Epidemiological knowledge is very poor in regards to anorectal disorders. The patients do not often discuss perianal symptoms leading to late diagnosis and treatment. There is a need of doing systematic questioning and clinical evaluation of the population to assess the prevalence of anorectal disorders. Aim and objectives: The aim of this study is to assess the prevalence of anorectal disorders among the residents of Kirtipur municipality in Nepal. Methods: The first section was the cross-sectional survey to assess the demographic and lifestyle characteristics of the study population. The second section was the observation study to assess the prevalence of anorectal symptoms. 1483 patients were recruited from 10 wards of Kirtipur municipality. We analyzed the comparison of diagnostic approach between patients with perianal symptoms spontaneously visited and those revealed after targeted questioning. We further analyzed the reason for not performing perianal examination by both patients and general practitioners. Factors associated with referral to a proctologist and diagnosis rate were also evaluated. Results: The study showed that the prevalence of anorectal symptoms increased from 9.4% to 21.2% after systematic targeted questioning by general practitioners. Spice intake was the only covariate associated with decrease risk of proctological symptoms. Haemorrhoids (31.2%) and anal fissure (28.7%) were the most prevalent anorectal disorders. However, physicians have diagnosed anorectal disorders in 20.2% of patients without performing any perianal examination. Diagnosis of haemorrhoids and fistula in ano were significantly associated with referral to a proctologist. Conclusion: This study may contribute to epidemiological knowledge about the prevalence of anorectal disorders among Nepalese population.