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Angus J M Watson, Jemma Hudson, Jessica Wood, Mary Kilonzo, Steven R Brown, Alison McDonald, John Norrie, Hanne Bruhn, Jonathan A Cook
BACKGROUND: Two commonly performed surgical interventions are available for severe (grade II-IV) haemorrhoids; traditional excisional surgery and stapled haemorrhoidopexy. Uncertainty exists as to which is most effective. The eTHoS trial was designed to establish the clinical effectiveness and cost-effectiveness of stapled haemorrhoidopexy compared with traditional excisional surgery. METHODS: The eTHoS trial was a large, open-label, multicentre, parallel-group, pragmatic randomised controlled trial done in adult participants (aged 18 years or older) referred to hospital for surgical treatment for grade II-IV haemorrhoids...
October 7, 2016: Lancet
S R Brown
The results of the Hubble trial, a randomised controlled trial comparing haemorrhoidal artery ligation with rubber band ligation for early-grade prolapsing haemorrhoids, are discussed. The difficulties in defining treatment success are debated along with the trial design highlighting the pitfalls of previous research. A finding that haemorrhoidal artery ligation is not necessarily superior to cheap alternatives has implications for current practice and future commissioning of surgeons.
October 3, 2016: Techniques in Coloproctology
Mariem Rekik, Khaoula Achour, Anouer Abdallah, Sonia Lebib, Imen Miri, Fatima Zahra Ben Salah, Catherine Dziri
OBJECTIVE: The aim of our study was to assess the bladder and sphincter function after brain injury (BI) and to review their association with quality of life (QOL). MATERIAL/PATIENTS AND METHODS: We conducted a cross-sectional study, including patients referred to physical and rehabilitation medicine department at the Med Kassab Institute of Orthopedics. The initial gravity data were collected. The bladder-sphincter assessment included evaluation of the urine drain mode, the irritative disorders, obstructive disorders, disorders of transit and the existence of secondary anal lesions...
September 2016: Annals of Physical and Rehabilitation Medicine
Björn Stessel, Michiel Boon, Elbert A Joosten, Jean-Paul Ory, Stefan Evers, Sander M J van Kuijk, Jasperina Dubois, Daisy Hoofwijk, Luc Jamaer, Wolfgang F F A Buhre
BACKGROUND: Postoperative pain and, in a more extended perspective, quality of recovery (QOR) should be considered the principal endpoints after day surgery. Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol are a cornerstone of pain treatment after painful day surgery. Nevertheless, NSAIDs are not always sufficiently effective, have numerous contraindications, and consequently are not suitable in up to 25 % of all patients. Metamizole is a non-opioid compound with a favourable gastrointestinal, cardiovascular and cerebrovascular profile compared to NSAIDs...
September 26, 2016: Trials
Cathlyn Akindiose, Olusegun Isaac Alatise, Olukayode Adeolu Arowolo, Augustine E Agbakwuru
OBJECTIVES: The objective of this study was to compare the efficacy and safety of 5% phenol in almond oil with 50% dextrose water as sclerosants in the treatment of first- to third-degree haemorrhoids. PATIENTS AND METHODS: This was a prospective, comparative study conducted on eighty patients with first-, second- and third-degree haemorrhoids who consented to treatment by injection sclerotherapy with either 5% phenol in almond oil or 50% dextrose water. They were randomised equally into two groups...
July 2016: Nigerian Postgraduate Medical Journal
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
RATIONALE, AIMS AND OBJECTIVES: Variation in the workup of rectal bleeding may result in guideline-discordant care and delayed diagnosis of colorectal cancer. Accordingly, we undertook this study to characterize primary care clinicians' initial rectal bleeding evaluation. METHODS: We studied 438 patients at 10 adult primary care practices affiliated with three Boston, Massachusetts, academic medical centres and a multispecialty group practice, performing medical record reviews of subjects with visit codes for rectal bleeding, haemorrhoids or bloody stool...
July 20, 2016: Journal of Evaluation in Clinical Practice
Showkat A Kadla, Nisar A Shah, Muzafar A Bindroo, Bilal A Khan, Adil Farooq, Wajeed Yousf, Bilal A Wani
BACKGROUND AND STUDY AIMS: Gastric cancer is highly prevalent in Kashmir, as are lower gastrointestinal (LGI) malignancies. Colonic cancer, gastric cancer, and coeliac disease are the most important gastrointestinal (GI) causes of iron deficiency anaemia (IDA) worldwide. Approximately 9% of patients with IDA present with a suspicious lesion in the GI tract upon examination. However, the absence of GI symptoms and a possible lesion accounting for blood loss in IDA have not been studied in this zone with a high prevalence of GI malignancy...
June 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Lukasz Dziki, Michal Mik, Radzislaw Trzcinski, Jaroslaw Buczynski, Anna Kreisel, Mariusz Skoneczny, Adam Dziki
INTRODUCTION: In cases of haemorrhoidal disease resistant to conservative treatment, surgical treatment is necessary to relieve the symptoms. AIM: To investigate the current methods used by Polish surgeons. MATERIAL AND METHODS: Surveys were distributed to members of the Association of Polish Surgeons (APS), in which participants were asked a number of closed-ended questions regarding haemorrhoidal disease and the way they treated suffering patients...
2016: Przegla̜d Gastroenterologiczny
N Moussa, I Sielezneff, M Sapoval, F Tradi, C Del Giuidice, N Fathalla, O Pellerin, G Amouyal, Pereira, V De Parades, V Vidal
AIM: The aim of this study was to assess the safety and efficacy of the emborrhoid technique (embolization of the superior hemorrhoidal arteries) in patients ineligible for surgery. MATERIALS AND METHODS: Between January 2014 and April 2015, 30 consecutive patients (average age 58 years) suffering from disabling chronic bleeding due to haemorrhoidal disease and with a contraindication for surgery (n= 23) or with a failure of instrumental or surgical treatment (n=7) underwent embolization...
June 24, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Eszter Riethmüller, Arpad Könczöl, Dorottya Szakál, Krisztina Végh, György T Balogh, Ágnes Kéry
Corylus avellana L., C. colurna L. and C. maxima Mill. have been used in traditional medicine for a long time for the treatment of various diseases, such as phlebitis, varicose veins, haemorrhoidal symptoms and eczema. Our previous studies indicated the presence of flavonol-3-O-glycosides, diarylheptanoids and caffeic acid derivatives in the bark and leaf extracts of the three species mentioned above. Comparison of in vitro DPPH scavenging activity of the Corylus extracts prepared with ethyl acetate and methanol to those of well-known antioxidant phenolics was performed...
May 2016: Natural Product Communications
Steven R Brown, James P Tiernan, Angus J M Watson, Katie Biggs, Neil Shephard, Allan J Wailoo, Mike Bradburn, Abualbishr Alshreef, Daniel Hind
BACKGROUND: Optimum surgical intervention for low-grade haemorrhoids is unknown. Haemorrhoidal artery ligation (HAL) has been proposed as an efficacious, safe therapy while rubber band ligation (RBL) is a commonly used outpatient treatment. We compared recurrence after HAL versus RBL in patients with grade II-III haemorrhoids. METHODS: This multicentre, open-label, parallel group, randomised controlled trial included patients from 17 acute UK NHS trusts. We screened patients aged 18 years or older presenting with grade II-III haemorrhoids...
July 23, 2016: Lancet
F Gaj, L Candeloro, I Biviano
AIM: In prolapsed internal hemorrhoids exposed outside the anus, manually reducing the prolapse with 48 hours of commencement of anal pain, decreased the progression of thrombosis. The aim of our study was to evaluate the effects of manual reduction of the inflamed piles hemorrhoids. MATERIALS OF STUDY: Eleven patients, 7 males and 4 pregnant females (in early post partum) with an average age of 34 years ± 8 (range 23- 52) were enrolled with anal pain cause by haemorrhoidal congestion, but prior to full blown thrombosis...
March 2016: La Clinica Terapeutica
Aldo Bove, Vincenzo D'Addetta, Gino Palone, Tarcisio Paniccia, Stella Chiarini, Alfonso Lapergola, Giuseppe Bongarzoni
BACKGROUND: Patients with haemorrhoids often present obstructive defecation symptoms. Preoperative they can be classified in three groups: slight, severe and mild symptoms. Aim of this study was to postoperatively evaluate functional outcome in patients who underwent stapled haemorrhoidectomy in mild obstructive defecation syndrome. METHODS: We enrolled 98 patients with mild obstructive defecation symptoms using Wexner score preoperatively (range 8-16) from the 332 consecutive patients treated with stapled haemorrhoidectomy between January 2009 and December 2011...
2016: Annali Italiani di Chirurgia
Andreia Albuquerque, Eduardo Pereira
Transperineal ultrasound is an inexpensive, safe and painless technique that dynamically and non-invasively evaluates the anorectal area. It has multiple indications, mainly in urology, gynaecology, surgery and gastroenterology, with increased use in the last decade. It is performed with conventional probes, positioned directly above the anus, and may capture images of the anal canal, rectum, puborectalis muscle (posterior compartment), vagina, uterus, (central compartment), urethra and urinary bladder (anterior compartment)...
April 28, 2016: World Journal of Radiology
José Francisco Juanmartiñena Fernández, Ignacio Fernández-Urien, Alicia Córdoba
Anorectal malignant melanoma (AMM) is most common primary melanoma of gastrointestinal tract, accounting for 0.05% and 1% of all colorectal and anal cancers. We reported an 85 year-old woman with no significant past medical history who presented two-month period of rectal bleeding, abdominal pain, tenesmus and 2kg weight-loss. Laboratory markers were unremarkable, although rectal examination revealed two small haemorrhoids and a firm, non-obstructing mass in the lower rectum. Colonoscopy confirmed presence of an ulcerated pigmented neoplasm arising at dental line [A,B]...
September 2016: Revista Española de Enfermedades Digestivas
Nikita R Bhatt, Michael R Boland, Omar Abdelraheem, Anne B Merrigan
Bleeding per rectum is a relatively common acute surgical presentation. Common causes include diverticular disease, colitis, haemorrhoids, polyps, etc. An 83-year-old man with a history of recurrent rectosigmoid diverticulitis and bilateral internal iliac artery aneurysms for 2 years presented with rectal bleeding. He was suspected to have a diverticular bleed based on history and examination. A CT scan revealed a large haematoma adjacent to the right isolated internal iliac artery aneurysm (IIIAA) almost indistinguishable from the adjacent rectosigmoid, consistent with a ruptured IIIAA and an ileorectal fistula...
2016: BMJ Case Reports
S R Brown, A Watson
OBJECTIVE: To review the efficacy and safety of the two most popular conventional methods of haemorrhoidal treatment, rubber band ligation and excisional haemorrhoidectomy (EH). The original study has now been updated using the same search strategy. SEARCH METHODS: We searched MEDLINE, EMBASE, CENTRAL, and CINAHL up to October 2010. SELECTION CRITERIA: Randomised controlled trials comparing rubber band ligation with EH for symptomatic haemorrhoids in adult human patients were included...
September 2016: Techniques in Coloproctology
Imteyaz Ahmad Khan, Sucharita Pilli, Surendranath A, Ritika Rampal, Sudhir Kumar Chauhan, Veena Tiwari, Venigalla Pratap Mouli, Saurabh Kedia, Baibaswata Nayak, Prasenjit Das, Govind K Makharia, Vineet Ahuja
BACKGROUND: Association of Mycobacterium avium subspecies paratuberculosis (MAP) and Crohn's disease (CD) has been controversial due to contradictory reports. Therefore, we determined the prevalence of MAP in patients with CD and intestinal tuberculosis (ITB) and its association with clinical course. METHODOLOGY: Blood and intestinal biopsies were taken from 69 CD, 32 ITB patients and 41 patients with haemorrhoidal bleed who served as controls. qPCR targeting of MAP-specific IS900 gene was used to detect the presence of MAP DNA...
2016: PloS One
Abhishek Mitra, Amitabh Yadav, Naimish Mehta, Vibha Varma, Vinay Kumaran, Samiran Nundy
Management of benign anorectal conditions like abscesses and haemorrhoids is usually uneventful. However, complicated perianal complications can result and have sparsely been reported in literature. Hereby, we report a series of seven patients who presented with rare sequelae like necrotising fasciitis, intraperitoneal or retroperitoneal involvement. All patients responded well to surgical management. Accordingly, complicated perianal sepsis warrants a timely and aggressive surgical intervention.
December 2015: Indian Journal of Surgery
Shahid Majeed, Syeda Rifaat Qamar Naqvi, Mohammad Tariq, Mohammad Asghar Ali
BACKGROUND: Haemorrhoids have been diagnosed and treated since the dawn of civilization, yet their cause, nature, symptomatology and especially their treatment options, remain hotly debated. The general principle however is that treatment should be directed by symptoms and the degree of haemorrhoids. The objective of the study is to compare early and late complications and wound healing time in open versus closed methods of haemorrhoidectomy. METHODS: This was a Randomized control trial conducted at Department of Surgery CMH Kharian for a period of 3 years...
October 2015: Journal of Ayub Medical College, Abbottabad: JAMC
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