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fissure in ano

Ali Reza Derakhshan
Most cases of chronic fissure do not respond to medical treatment. Razi and Ibn Sina were 2 of the best-known scientists of ancient Persia. The purpose of this study was to find out new scientific evidence in modern medicine about their recommendations, in order to find certain clues to conduct useful researches in the future. First, treatments of anal fissure mentioned by Razi and Ibn Sina were reviewed. Then, literature search was made in electronic databases including PubMed, Scopus, and Google Scholar. Management of anal fissure according to Razi's and Ibn Sina's practices is done based on 3 interventions: lifestyle modifications, drug treatments, and manual procedures...
June 8, 2016: Journal of Evidence-based Complementary & Alternative Medicine
Rajan Vaithianathan, Senthil Panneerselvam
Fissure in ano is a very common disorder of the anorectal region. Internal sphincter hypertonia with decreased relaxation coupled with mucosal ischemia of posterior anal canal are the major pathologies in chronic anal fissure (CAF). Though lateral internal sphincterotomy (LIS) remains the gold standard of treatment for the disease, it is accompanied by the potential complication of incontinence to both flatus and faecal matter. The aim of our study was to explore the role of topical diltiazem as an effective and a safe alternative to sphincterotomy for chronic anal fissure...
December 2015: Indian Journal of Surgery
Nighat Ghayas, Syed Muneeb Younus, Abdul Jabbar Mirani, Mohammed Ghayasuddin, Aamna Qazi, Sunil Dutt Suchdev, Saqib Kamran Bakshi
BACKGROUND: Fissure in ano is one of the commonest benign and painful proctologic diseases causing considerable morbidity and reduction in quality of life. There are medical as well as surgical treatment options for anal fissure. The study was conducted to compare the frequency of postoperative faecal incontinence in patients with closed lateral internal anal sphincterotomy with von-greaves knife versus standard Park's operation (open method) for chronic anal fissure. METHODS: This was a randomized controlled trial (RCT) was conducted at the Department of Surgery, KVSS, S...
October 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Jennifer Sam Beaty, M Shashidharan
Anal fissure (fissure-in-ano) is a very common anorectal condition. The exact etiology of this condition is debated; however, there is a clear association with elevated internal anal sphincter pressures. Though hard bowel movements are implicated in fissure etiology, they are not universally present in patients with anal fissures. Half of all patients with fissures heal with nonoperative management such as high fiber diet, sitz baths, and pharmacological agents. When nonoperative management fails, surgical treatment with lateral internal sphincterotomy has a high success rate...
March 2016: Clinics in Colon and Rectal Surgery
F Gaj, L Candeloro, I Biviano
BACKGROUND AND AIMS: Our experience in colon-proctology showed the need to update the post-surgical complications score we published (1), adding others that may have an impact on outcome of treatment. The aim of this study was to assess the efficacy of a score obtained from the analysis of the quality of life and severity of complications after proctologic surgery. MATERIALS AND METHODS: Between January and December 2013, we studied 150 patients undergoing several ano-rectal surgeries for the presence of hemorrhoids of grade III and IV (63 patients), anal fissures (42 patients), anal fistulas (19 patients), rectocele (15 patients) and mucosal prolapse of the rectum (11 patients)...
2015: La Clinica Terapeutica
F Soliman, G Sturgeon, R Hargest
OBJECTIVE: The history of treatments for fistula-in-ano can be traced back to ancient times. Current treatment of transphincteric fistulae is controversial, with many options available. We reviewed the history of treatment using cutting setons and present our series of transphincteric fistulae in the light of the series in the literature. DESIGN: Literature review and case series. SETTING: Hospital based coloproctology service PARTICIPANTS: 140 consecutive patients presenting with fistula-in-ano were included...
December 2015: Journal of the Royal Society of Medicine
Andreas Ommer
BACKGROUND: Fistula-in-ano and anal fissures are common proctological diseases. In most cases of anal fissures conservative treatment provides good clinical results, whereas for fistula-in-ano operative treatment is the only option. OBJECTIVE: The most important and for the patient most stressful long-term complication is postoperative incontinence, especially as the deliberate severance of the anal sphincter musculature is part of the treatment for many patients...
August 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Vijaya Kumari Kurapati, K Nishteswar
BACKGROUND: Ano-rectal complaints are usually benign in origin. Most of the patients suffering with these disorders do not seek medical advice at an early stage due to embarrassment. It results in advancement of the disease and significant disturbance in the quality of life. Among the available treatment modalities of ano-rectal disorders (ARDs), Kṣārasūtra (medicated thread) appears to be the best in terms of relief and nonrecurrence. AIMS AND OBJECTIVES: The aim of this study is to provide evidence-based data about the practical application of Kṣārasūtra (medicated thread) in the management of ARDs...
October 2014: Ancient Science of Life
Tukaram S Dudhamal, Madhav Singh Baghel, Chaturbhuja Bhuyan, Sanjay Kumar Gupta
BACKGROUND: Parikartika resembles fissure-in-ano which is very common among all ano-rectal disorders. In Ayurvedic texts, Parikartika is described as a complication of Vamana and Virechana as well as complication of Atisara. Ksharasutra was proved successful in the management of fistula-in-ano, piles, and there is a need to try its efficacy in fissure-in-ano. AIM: To evaluate the role of Ksharasutra suturing (KSS) in fissure bed in chronic fissure-in-ano. MATERIALS AND METHODS: Total 100 patients of chronic fissure-in-ano were selected and randomly divided into two groups (50 in each group)...
April 2014: Ayu
Kemal Peker, Ismayil Yilmaz, Ismail Demiryilmaz, Abdullah Inal, Arda Işik
BACKGROUND/AIM: Anal fissures are one of the most common proctologic disorders. This study aimed to investigate alterations in anal sphincteric resting pressures after lateral internal sphincterotomy, which was performed for chronic anal fissure treatment. MATERIALS AND METHODS: Fifty-six (68.3%) male and 26 (31.7%) female patients were included in this study. Patients complicated with fistula-in-ano, abscess, cancer, inflammatory bowel disease, dermatitis, poor general condition, allergy to any of the standard medications, previous history of anal trauma, previous anal surgery, or diagnosis of a neurological disease and patients who did not give consent to the trial were excluded from the study...
2014: Turkish Journal of Medical Sciences
Giridhar C M, Preethitha Babu, K Seshagiri Rao
INTRODUCTION: Anal fissures are commonly encountered in routine clinical practice. Anal fissure has traditionally been treated surgically. Developments in the pharmacological understanding of the internal anal sphincter have resulted in more conservative approaches towards treatment. In this study we compare symptomatic relief, healing and side effects of topical 2% Diltiazem gel and lateral internal sphincterotomy in the treatment of chronic fissure in ano. MATERIALS AND METHODS: In this prospective trial, 60 surgical out patients and/or admitted patients with chronic fissure in ano were randomly divided into Group 1 (Diltiazem gel) and Group 2 (internal sphincterotomy) with 30 patients in each Group...
October 2014: Journal of Clinical and Diagnostic Research: JCDR
Amyn Pardhan, Rizwan Azami, Samia Mazahir, Ghulam Murtaza
OBJECTIVE: To further resolve the clinical equipoise on the choice of chemical sphincterotomy agent for early symptomatic relief of anal fissure by comparing the effectiveness of 2% Diltiazem gel with 0.2% Glyceryl TriNitrate. METHODS: The randomized clinical trial was conducted at Aga Khan University Hospital, Karachi, from February 1, to July 30, 2008, and comprised 60 adult patients with anal fissure who were equally randomised to either Diltiazem or Glyceryl TriNitrate after taking informed consent...
May 2014: JPMA. the Journal of the Pakistan Medical Association
Ridzuan Farouk
PURPOSE: To estimate the risk of recurrent fissure in ano after sphincter preserving treatments. METHODS: A retrospective case note review, combined with a telephone survey was conducted for all patients treated for a chronic anal fissure between 1998 and 2008. RESULTS: Six hundred and twelve patients (303 women: mean age, 39 years; range, 16-86 years) were treated for chronic anal fissure between 1998 and 2008. Topical diltiazem 2% was initially prescribed for 8 weeks...
June 2014: Annals of Coloproctology
I I Gribanov
No abstract text is available yet for this article.
2013: Experimental & Clinical Gastroenterology
Christopher J Hobbs, Charlotte M Wright
BACKGROUND: There is uncertainty about the nature and specificity of physical signs following anal child sexual abuse. The study investigates the extent to which physical findings discriminate between children with and without a history of anal abuse. METHODS: Retrospective case note review in a paediatric forensic unit. CASES: all eligible cases from 1990 to 2007 alleging anal abuse. CONTROLS: all children examined anally from 1998 to 2007 with possible physical abuse or neglect with no identified concern regarding sexual abuse...
2014: BMC Pediatrics
Muhammad Asim, Neil Lowrie, Joanna Stewart, Simi Lolohea, Ralph Van Dalen
BACKGROUND: Chronic anal fissure (CAF) is perpetuated by high sphincter pressures and secondary local ischemia. Pharmacological approaches include topical nitrates and botulinum toxin (BT), which both help to decrease the sphincter pressure. AIMS & OBJECTIVES: The aims of the present study were to assess the efficacy and safety of BT injection and combined treatment with BT injection and lowered dose glyceryltrinitrate (GTN) cream for the treatment of CAF. We hypothesised that combined treatment would have a synergistic effect on healing...
2014: New Zealand Medical Journal
Audralan Fox, Pamela H Tietze, Kalyanakrishnan Ramakrishnan
Anal fissures are linear splits in the anal mucosa. Acute fissures typically resolve within a few weeks; chronic fissures persist longer than 8 to 12 weeks. Most fissures are posterior and midline and are related to constipation or anal trauma. Painful defecation and rectal bleeding are common symptoms. The diagnosis typically is clinical. High-fiber diet, stool softeners, and medicated ointments relieve symptoms and speed healing of acute fissures but offer limited benefit in chronic fissures. Lateral internal sphincterotomy is the surgical management of choice for chronic and refractory acute fissures...
April 2014: FP Essentials
I I Gribanov
The original material of monitoring of 118 patients with chronic anal fissure is presented in the article. Patients' mean age was 48.9+-10.5 years. It was used injections of medicine of botulinum toxin of type A (Lantox) by its introduction in internal anal sphincter in all patients. There was granulating wound with signs of marginal epithelialization in 59.3% of cases on the 10th day after injection. It was detected complete epithelialization of dermis defect in 93.2% of cases on the 21st day, after six weeks - in 100% of cases...
2014: Khirurgiia
O Pittet, N Demartines, D Hahnloser
Anal pain is a common reason for consultation, whose etiology is varied and should not be limited to the hemorrhoidal disease. The purpose of this article is to conduct a review of the literature on anorectal pathologies most frequently encountered and make recommendations regarding their management.
March 5, 2014: Revue Médicale Suisse
Deborah Tolmach Sugerman
No abstract text is available yet for this article.
March 19, 2014: JAMA: the Journal of the American Medical Association
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