Patient presents with complaints concerning rectal conditions, possibly including rectal pain, rectal bleeding, rectal itching, rectal pressure, or changes in bowel habits.  Onset, duration, frequency, and character of symptoms were documented.  Associated symptoms such as abdominal pain, constipation, diarrhea, tenesmus, incontinence, mucous discharge, or presence of a mass were explored.  Past medical history, including hemorrhoids, anal fissures, fistula, proctitis, rectal prolapse, diverticulitis, inflammatory bowel disease (Crohn's disease, ulcerative colitis), colon cancer, and previous rectal surgery, was reviewed.  Family history of colorectal cancer or other relevant conditions was noted.  Medications, including over-the-counter and prescription drugs, were documented.  Allergies were reviewed.  Social history, including diet, exercise, smoking, and alcohol use, was obtained.  Physical examination included a digital rectal exam assessing for anal sphincter tone, masses, tenderness, and bleeding.  The perianal area was inspected for fissures, fistulae, and external hemorrhoids.  Diagnostic considerations include anoscopy, proctoscopy, sigmoidoscopy, colonoscopy, and stool tests (fecal occult blood test, fecal calprotectin).  Differential diagnosis includes hemorrhoids, anal fissures, perirectal abscess, anal fistula, proctitis, rectal prolapse, colorectal cancer, and irritable bowel syndrome.  Treatment plan may include conservative management (e.g., high-fiber diet, stool softeners, sitz baths), topical medications (e.g., corticosteroids, local anesthetics), or surgical intervention depending on the diagnosis.  Patient education regarding proper bowel habits, hygiene, and follow-up care was provided.  Referral to a gastroenterologist or colorectal surgeon may be indicated depending on the diagnosis and severity of the condition.  Follow-up appointment scheduled for reassessment and discussion of further management.