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Anal Fissure

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https://www.readbyqxmd.com/read/28629768/does-the-duration-of-symptoms-of-anal-fissure-impact-its-response-to-conservative-treatment-a-prospective-cohort-study
#1
Sameh Hany Emile, Hesham Elgendy, Hossam Elfeki, Alaa Magdy, Ahmed Aly Abdelmawla, Mahmoud Abdelnaby, Wael Khafagy
BACKGROUND: Conservative treatment is the first line of treatment for anal fissure. The current study aimed to evaluate the impact of symptom duration on the response of anal fissure to conservative treatment. PATIENTS AND METHODS: This prospective study was conducted on sixty patients with acute or chronic anal fissure who were treated conservatively with bulking agents, Sitz baths, and topical glyceryl trinitrate (GTN) 0.2%. Pain and constipation were assessed prior to treatment and at 6 weeks after therapy using visual analogue scale (VAS) and Wexner constipation score...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28629764/oral-versus-topical-calcium-channel-blockers-for-chronic-anal-fissure-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
REVIEW
Shaheel M Sahebally, Khalid Ahmed, Raminta Cerneveciute, Asif Iqbal, Stewart R Walsh, Myles R Joyce
BACKGROUND: Chemical sphincterotomy with pharmacological agents is recommended as first line therapy for chronic anal fissures (CAF). Calcium channel blockers (CCB) are associated with similar efficacy but fewer side effects compared to nitrates. However, the optimal formulation (oral versus topical) is unknown. We aimed to perform a systematic review and meta-analysis to compare the effectiveness of oral and topical CCB in the treatment of CAF. METHODS: PubMed and Embase online databases were searched for relevant articles...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28598453/effectiveness-of-0-2-glyceryl-trinitrate-and-0-5-nifedipine-in-the-treatment-of-chronic-anal-fissure
#3
S K Shrestha, P B Thapa, D K Maharjan, T Y Tamang
INTRODUCTION: Anal fissure is an ischemic ulcer caused by combination of spasm of internal anal sphincter and poor blood supply to the posterior midline of anal canal. This study aimed to assess the efficacy of Glyceryl Trinitrate and Nifedipine in the treatment of chronic anal fissure. METHODS: Ninety patients with symptomatic anal fissure in Kathmandu Medical College Teaching Hospital are allocated for study in two groups of 45 each from March 2013 to April 2014...
January 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28574663/a-novel-method-for-treatment-of-chronic-anal-fissure-adipose-derived-regenerative-cells-a-pilot-study
#4
K Andjelkov, M Sforza, G Barisic, I Soldatovic, A Hiranyakas, Z Krivokapic
AIM: The purpose of this study was to investigate the safety and feasibility of autologous adipose-derived regenerative cells (ADRC) in the treatment of chronic anal fissure. METHOD: A prospective pilot study was conducted in six patients with chronic anal fissures at the First Surgical Clinic, Clinical Center of Serbia and at the BelPrime Clinic, Belgrade, Serbia. All patients were candidates for surgical treatment. The average duration of symptoms was 24 months...
June 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28567655/the-evaluation-and-office-management-of-hemorrhoids-for-the-gastroenterologist
#5
REVIEW
Mitchel Guttenplan
PURPOSE OF REVIEW: Hemorrhoid disease is extremely common, and seldom requires surgical intervention. The vast majority of patients can be cared for in the office setting and by the gastroenterologist. This piece aims to summarize the epidemiology and pathophysiology of hemorrhoid disease, along with the proper evaluation and office-based treatment of these patients. RECENT FINDINGS: Most GI fellowship training programs spend little time on these topics, and the recommendation has been made to include anorectal care in the GI's "core curriculum...
July 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28514300/increasing-efficacy-and-reducing-side-effects-in-treatment-of-chronic-anal-fissures-a-study-of-topical-diazepam-therapy
#6
Minh Tuan H Hang, Betsy E Smith, Carson Keck, Ali Keshavarzian, Shahriar Sedghi
This is a single institution nonexperimental study intended to analyze the therapeutic efficacy of topical diazepam in treating symptoms of chronic anal fissures.Anal fissures are a common cause of anal pain. Conventional treatments include nonsteroidal anti-inflammatory drugs, topical creams, such as nitroglycerin and nifedipine, and surgery. However, these treatments are usually suboptimally efficacious or have deterring side effects.Patients at an outpatient community center with a diagnosis of a chronic anal fissure were prescribed either topical 2% (n = 19) or 4% (n = 18) diazepam cream between January 2013 and February 2015...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28471820/prevalence-of-intestinal-complications-in-inflammatory-bowel-disease-a-comparison-between-paediatric-onset-and-adult-onset-patients
#7
Denise Herzog, Nicolas Fournier, Patrick Buehr, Vanessa Rueger, Rebekka Koller, Klaas Heyland, Andreas Nydegger, Christian P Braegger
INTRODUCTION: Intestinal complications in inflammatory bowel disease indicate active inflammation and typically result in the intensification of therapy. AIM: To analyse whether the rates of intestinal complications were associated with age at disease onset. PATIENTS AND METHODS: Data from 1506 individuals with Crohn's disease (CD) and 1201 individuals with ulcerative colitis (UC) were obtained from the Swiss inflammatory bowel disease cohort study database, classified into groups on the basis of age at diagnosis (<10, <17, <40 and >40 years of age), and retrospectively analysed...
May 3, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28434175/myoxinol-ointment-for-the-treatment-of-acute-fissure
#8
J Martellucci, G Rossi, I Corsale, P Carrieri, M D'Elia, I Giani
Myoxinol is a complex of oligopeptides obtained from the seeds of Hibiscus esculentus used in cosmetic as natural alternative to botulin toxin. The aim of the study was to evaluate the safety and effectiveness of local myoxinol for the treatment of acute anal fissure. All the consecutive patients with acute fissure treated from January to June 2014 underwent 30 days of topical treatment (twice/day) with a mioxinol based ointment. Pain, symptomatic relief, fissure healing and re-epithelization, 1-year recurrence rate, subjective satisfaction and need for further treatments were evaluated...
April 22, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28432678/anal-metastasis-of-rectal-cancer-adenocarcinoma-of-squamous-cells-a-case-report-and-literature-review
#9
Shun Sasaki, Masahiko Sugiyama, Yu Nakaji, Ryota Nakanishi, Yuichiro Nakashima, Hiroshi Saeki, Eiji Oki, Yoshinao Oda, Yoshihiko Maehara
Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28412052/-the-relationship-between-preoperative-anxiety-levels-and-vasovagal-incidents-during-the-administration-of-spinal-anesthesia
#10
Mürsel Ekinci, Birzat Emre Gölboyu, Onur Dülgeroğlu, Murat Aksun, Pınar Karaca Baysal, Erkan Cem Çelik, Ayşe Nur Yeksan
BACKGROUND: It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions. METHODS: The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Patients were evaluated in respect of demographic characteristics, smoking and alcohol consumption, ASA grade and educational level...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28410787/efficacy-of-nitroglycerine-ointment-in-the-treatment-of-pediatric-anal-fissure
#11
Ali E Joda, Ali F Al-Mayoof
BACKGROUND: Anal fissure is the most common anal disease in children. In the past few decades, the understanding of its pathophysiology has led to a progressive reduction in invasive procedures in favor of conservative treatment based on stool softeners and the relaxation of the anal sphincter. This randomized controlled study assessed the safety and efficacy of nitroglycerine (NTG) ointment in the treatment of pediatric anal fissure, which had not yet been proved. PATIENTS AND METHODS: An unequal randomized controlled study included 105 pediatric patients with anal fissure who had presented to the private and outpatient clinics of the Central Teaching Hospital of Pediatrics during the period from February 2015 to May 2016...
April 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28396998/operative-and-medical-treatment-of-chronic-anal-fissures-a-review-and-network-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Sabrina Maria Ebinger, Julia Hardt, René Warschkow, Bruno Martin Schmied, Alexander Herold, Stefan Post, Lukas Marti
Anal fissures are a common problem and have a cumulative lifetime incidence of 11%. Previous reviews on anal fissures show inconsistent results regarding post-interventional healing and incontinence rates. In this review our aim was to compare the treatments for chronic anal fissures by incorporating indirect comparisons using network meta-analysis. The PubMed database was searched for randomized controlled trials (RCTs) published between 1975 and 2015. The primary outcome measures were healing and incontinence rates after lateral internal sphincterotomy (LIS), anal dilatation (DILA), anoplasty and/or fissurectomy (FIAP), botulinum toxin (BT) and noninvasive treatment (NIT)...
June 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28373769/predictive-factors-for-compliance-with-transanal-irrigation-for-the-treatment-of-defecation-disorders
#13
Clémence Bildstein, Chloé Melchior, Guillaume Gourcerol, Estelle Boueyre, Valérie Bridoux, Eric Vérin, Anne-Marie Leroi
AIM: To investigate compliance with transanal irrigation (TAI) one year after a training session and to identify predictive factors for compliance. METHODS: The compliance of one hundred eight patients [87 women and 21 men; median age 55 years (range 18-83)] suffering from constipation or fecal incontinence (FI) was retrospectively assessed. The patients were trained in TAI over a four-year period at a single institution. They were classified as adopters if they continued using TAI for at least one year after beginning the treatment or as non-adopters if they stopped...
March 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28367179/comparison-of-two-procedures-for-symptomatic-hemorrhoidal-disease-ligation-under-vision-and-ferguson-hemorrhoidectomy-a-retrospective-cohort-study
#14
Hakan Demir, Kerem Karaman, Metin Ercan, Havva Belma Kocer, Fehmi Celebi
OBJECTIVE: To compare Ligation under Vision (LUV) with Ferguson Hemorrhoidectomy (FH) in patients with Grade II, III and IV hemorrhoidal diseases according to their postoperative outcomes. METHODS: Between July 2008 and August 2014, 155 patients underwent FH and 120 patients LUV, in Sakarya University Teaching and Research Hospital. Our retrospective analysis focuses on postoperative complications, postoperative pain and rate of recurrence. In LUV procedure, submucosal tissue of the hemorrhoidal pile base was transfixed using absorbable sutures under direct vision through anoscope in the Jackknife position...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28344798/long-term-outcomes-of-botulinum-toxin-in-the-treatment-of-chronic-anal-fissure-5-years-of-follow-up
#15
Sandra Barbeiro, Catarina Atalaia-Martins, Pedro Marcos, Cláudia Gonçalves, Manuela Canhoto, Bruno Arroja, Filipe Silva, Isabel Cotrim, Liliana Eliseu, Antonieta Santos, Helena Vasconcelos
BACKGROUND: Chronic anal fissure is a frequent and disabling disease, often affecting young adults. Botulinum toxin and lateral internal sphincterotomy are the main therapeutic options for refractory cases. Botulinum toxin is minimally invasive and safer compared with surgery, which carries a difficult post-operative recovery and fecal incontinence risk. The long-term efficacy of Botulinum toxin is not well known. OBJECTIVE: The aim of this study was to evaluate the long-term efficacy and safety of Botulinum toxin in the treatment of chronic anal fissure...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28274000/lateral-anal-sphincterotomy-for-chronic-anal-fissures-a-comparison-of-outcomes-and-complications-under-local-anaesthesia-versus-spinal-anaesthesia
#16
Ravikumar Manoharan, Tarun Jacob, Santosh Benjamin, Sumonth Kirishnan
INTRODUCTION: Fissure-in-Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Anal Spincterotomy (LAS) remains the gold standard of treatment for Chronic Anal Fissures (CAF). However, LAS is often done under spinal or general anaesthesia incurring huge treatment costs and hospital stay. AIM: To study if LAS can be treated with Local Anaesthesia (LA) thereby, reducing the costs and the anaesthetic risk to patients with no significant change in the surgical ease or clinical outcome...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28239456/chronic-anal-fissures-open-lateral-internal-sphincterotomy-result-a-case-series-study
#17
Abdulwahid M Salih
INTRODUCTION: Anal fissure are defined as a tear in the skin of the anal canal distal to dentate line. Although still there are controversies about the exact management, lateral sphincterotomy is promising. The aim of this series is to present the outcome of lateral sphincterotomy for internal anal sphincter in term of patient satisfaction and complication. PATIENT AND METHODS: A prospective single cohort study, 190 patients, who were undergone lateral sphincterotomy for internal anal sphincter from 2010 to 2014, were analyzed...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28039531/stress-and-psychopathology-and-its-impact-on-quality-of-life-in-chronic-anal-fissure-caf-patients
#18
Özden Arısoy, Neriman Şengül, Affan Çakir
BACKGROUND: Chronic anal fissure (CAF) onset, exacerbation, and impact on quality of life are influenced by a host of psychological, physiological, and social factors. We aimed to investigate the difference in psychopathology and stress between normal and CAF groups. METHODS: Thirty CAF patients and 20 age-sex matched healthy controls were evaluated for Axis I psychopathology, depression, anxiety, and stress with Hamilton and Hospital Depression-Anxiety Scales, Perceived Stress Scale, and SF-36...
June 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28029666/comparison-of-fissure-healing-and-the-incidence-of-headache-among-the-patients-treated-with-endo-and-perianal-application-of-0-2-glyceryl-trinitrate-for-chronic-anal-fissure
#19
M R Joshi, T P Bohara, S Rupakheti
INTRODUCTION: Chronic anal fissure is associated with significant morbidity and reduction in quality of life mostly in young healthy adults. Glyceryl Trinitrate, a most commonly used agent for treatment, is associated with incidence of headache causing discontinuation of treatment. There is belief that endoanal application instead of perianal is associated with lower incidence of headache. This study is to compare the incidence and severity of headache in between perianal and endoanal application of GTN ointment...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27981821/low-energy-manual-anal-stretch-an-approach-in-the-treatment-of-chronic-anal-fissure
#20
Fabio Gaj, Ivano Biviano, Laura Candeloro
BACKGROUND: Anal fissure is a tear in the epitelial lining of the anal canal. This is a very common anorectal disorder, but the choice of treatment is unclear. Sphincterotomy is effective but it is affected by a high risk of fecal incontinence. Manual anal stretch is aN efficacious, economic and safe maneuver. The aim of this prospective study was to assess the safety and effectiveness of anal stretch in resolving chronic anal fissures. METHODS: Twenty-five patients with a clinical diagnosis of chronic anal fissure were submitted to anal stretch...
April 2017: Minerva Chirurgica
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