ABSTRACT: Anorectal disorders can have overlapping symptoms, which sometimes can make it difficult to establish a diagnosis. Obtaining a detailed history and performing a physical examination are vital to establish the correct diagnosis and to outline appropriate treatment for anorectal disorders. Obstetrician–gynecologists often are the primary care providers and may be the only medical professional a woman sees; therefore, they should be knowledgeable regarding anorectal pathology, recommended dietary and lifestyle changes, and appropriate referral guidelines. This monograph reviews benign and malignant anorectal conditions to aid obstetrician–gynecologists in diagnosis and management of anorectal disease and to provide guidance regarding a referral to a gastroenterologist or a colorectal surgeon.
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![Figure 2. Representative image of the pelvic floor ligaments and their relative anatomical positions in a female model. (Salvador JC, Coutinho MP, Venâncio JM, Viamonte B. Dynamic magnetic resonance imaging of the female pelvic floor-a pictorial review. Insights Imaging 2019;10:4–9 . This figure is distributed without any changes under the terms of the Creative Commons Attribution 4.0 International License [ http://creativecommons.org/licenses/by/4.0/ ], which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author[s] and the source, provide a link to the Creative Commons license, and indicate if changes were made.)](/-/media/project/acog/acogorg/clinical/images/clinical-updates/2020/09/anorectaldisorders/cu097-20200900-fig2.png)
![Figure 3. Tricompartment pelvic organ prolapse with cystocele, enterocele, and rectal prolapse. In the rectum, a balloon catheter is visible. A. T2-weighted sagittal image. B. Axial view with clear opening of the pelvic hiatus and prolapse of the bladder base and small-bowel loops (cystocele and enterocele). (Maccioni F, Alt CD. MRI of the pelvic floor and MR defecography. In: Hodler J, Kubik-Huch RA and von Schulthess GK, editors. Diseases of the abdomen and pelvis 2018-2021. Cham, Switzerland: Springer; 2018. p. 13-20. This figure is distributed without any changes under the terms of the Creative Commons Attribution 4.0 International License http://creativecommons.org/licenses/by/4.0/ ], which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author[s] and the source, provide a link to the Creative Commons license, and indicate if changes were made.)](/-/media/project/acog/acogorg/clinical/images/clinical-updates/2020/09/anorectaldisorders/cu097-20200900-fig3.png)
