{"text":"Page 2 of 3 \nCLINICAL INFORMATION \nHistory of presenting complaint \nPresenting complaint \nDescription: ? Polyposis ani : \nComment: I would be very grateful if you could see this girl who has caused me something of a puzzle today. \nShe has presented complaining of finding loads of little lumps around about her anal ring and these cause her \npain when she is defecating.and sometime is some positions when sitting. On examination today, I was very \nsurprised to find an extremely heavy occurrence of polypoid warty lesions all the way round her anal ring three \ndeep In some cases and very heavily clustered. These I think were just inside, but it was difficult to examine \ndue to being painful for her. She has one or two isolated individual lesions in the perineal area but none in the \nGU area. I initlally wondered If this was a sexually transmitted problem, but she is adamant and I have no \nreason to not to believe her that she has not had any sexual contact of this nature in this area at any point in \nher sexually active life and she certainly has no other GU problems that would lead me to think that this is \nlikely to be a risk. She is.completely well otherwise and has no other symptoms. She has no altered bowel habit \nand has had no blood PR. I am uncertain as to what has caused these to occur and feel that she may need \nfurther Investigation of her lower GI tract. Thank you very much for assessing this. \nKind regards. \nYours sincerely \nReason for referral \nCare type requested: Out Patient ' \nExpected outcome: Not Specified \nPast medical history \nPre-existing conditions (High & medium priority - all) \nDescription , Comment Date of onset Date recorded \nBody mass index less than 20 - . - 29-Jul-2008 \nReminded In surgery Smear now Due - | - 11-Oct-2007 \nPatients Notes Summarised - 13-3ul-2006 13-Jul-2006 \nTermination of pregnancy medical 22-Apr-2006 22-Apr-2006 \nH\/O: depression and suicidal ideation 15-Feb-2005 15-Feb-2005 \nDrug addiction CODEINE 03-Sep-2002 03-Sep-2002 \n[V]Tuberculosis (BCG) vaccination - 23-May-1995 23\u2014May-1995 \nSchool problem extreme school avoidance 01-Jan-1995 01-Jan-1995 \nPast procedures (High and medium priority - alf) _ \n'Description Date performed Pate recorded \nSmoking cessation advice \u2018 - ) 17-Mar-2010 \nSmoking cessation advice - 22-Sep-2009 - \nSmoking cessation advice .- 29-Jul-2008 \nSmoking cessation advice - 04-Jui-2007 \nSmoking cessation advice - ' 04-Sep-2006 \nSmoking cessation advice - 17-Mar-2006 \nDrug addiction detoxification therapy - methadone 17-Nov-2005 17-Nov-2005 \nHealth ed. - smoking - 23-Jan-2004 \n1 Smoking cessation advice - 23-Jan-2004 \nReferral to community drug dependency team 30-Oct-2002 30-0ct-2002 \nRubelia vaccination 01-Nov-1993 01-Nov-1993 \nCusrrent medication (Active Repeat medication issued within the last 12 months) \nDrug name Quantity Formulation Dosage Frequency Date started Date last issued \nMirtazapine 56 TABS 45MG 1 Tab disp monthly At night 14-Dec-2009 14-Oct-2010 \nRecent medication (Any medication issued within last 168 days not shown above) \nDrug name Quantity Formulation Dosage Freguency Date started Date last issued \nfile:\/\/\/N:\/PCTI\/Docman7\/Data_S1\/Document\/DMEDOC01\/00003900\/00494883 HTM 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