Initially, the locally inflamed crypts produce no symptoms, but as the trauma from recurrent diarrhea or passage of large, hard stools continues, the inflammation of the crypts extends to the adjacent papillae, producing an edematous swelling of the sensitive anoderm that lines this part of the canal. At this stage, the patient will experience pain with bowel movements, and if there is an associated papillitis or fissure in ano, there will also be a small amount of bleeding. Anal pain, spasm, and itching with or without bleeding are the cardinal signs and symptoms of cryptitis.
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