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2. Anal fissure

Anal fissure Anal fissure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Anal fissure Last reviewed: February 2019 Last updated: March 2018 Summary Causes severe pain on defecation, often described as 'like passing broken glass'. The pain may continue for 1 to 2 hours and can also be burning in nature. A small amount of fresh red blood is often passed on the stool. On examination of the anus, there is often marked (...) spasm of the sphincter muscles, with significant tenderness often precluding digital examination. Initial treatment should include either topical glyceryl trinitrate or diltiazem, along with a programme of supportive care. Resistant or chronic fissures may benefit from botulinum toxin A, and most cases can be cured by surgical sphincterotomy or anal advancement flap. Definition Anal fissure is a split in the skin of the distal anal canal characterised by pain on defecation and rectal bleeding

2018 BMJ Best Practice

3. Letter to the editor on "Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: A prospective randomised study". Our results in the patients who undergone to secondary healing following the fissure tract excisi (PubMed)

Letter to the editor on "Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: A prospective randomised study". Our results in the patients who undergone to secondary healing following the fissure tract excisi 29037883 2019 02 11 2019 02 15 0219-3108 40 6 2017 Nov Asian journal of surgery Asian J Surg Letter to the editor on "Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: A prospective randomised (...) study". Our results in the patients who undergone to secondary healing following the fissure tract excision for primary chronic anal fissure. 495-497 S1015-9584(17)30421-9 10.1016/j.asjsur.2017.09.002 Yücesoy Ali Naki AN General Surgery Department, Batı Bahat Hospital, Istanbul, Turkey. Electronic address: alinakiyucesoy@gmail.com. eng Letter 2017 10 14 China Asian J Surg 8900600 1015-9584 IM Adolescent Adult Anal Canal surgery Chronic Disease Debridement Dilatation methods Fecal Incontinence

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2019 Asian Journal of Surgery

4. Clinical Practice Guideline for the Management of Anal Fissures

Clinical Practice Guideline for the Management of Anal Fissures Copyright © The American Society of Colon & Rectal Surgeons, Inc. Unauthorized reproduction of this article is prohibited. 7 Diseases of the Colon & ReCtum Volume 60: 1 (2017) t he a merican s ociety of Colon and Rectal surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention, and manage- ment of disorders and diseases of the colon, rectum, and anus. t he Clinical Practice Guidelines (...) regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances pre- sented by the individual patient. STATEMENT OF THE PROBLEM t he term anal fissure most commonly refers to a longitudi- nal tear within the anal canal, one that typically extends from the dentate line toward the anal verge. t his benign anorectal ailment is quite common, although there have been virtu- ally no published 1 population-level data describing its inci- dence. Constipation

2017 American Society of Colon and Rectal Surgeons

5. A Case Series of Anal Carcinoma Misdiagnosed as Idiopathic Chronic Anal Fissure (PubMed)

A Case Series of Anal Carcinoma Misdiagnosed as Idiopathic Chronic Anal Fissure Chronic anal fissure is a linear ulcer in the anal canal that has not cicatrized for more than 8-12 weeks of treatment. Most anal fissures are idiopathic and are located in the posterior midline. Squamous cell carcinoma of the anus commonly presents as bleeding and anal pain. It may also present as a mass, nonhealing ulcer, itching, discharge, fecal incontinence and fistulae. Not uncommonly, small and early cancers (...) are misdiagnosed as benign anorectal disorders like anal fissures or hemorrhoids. The clinical suspicion of squamous cell carcinoma of the anus is of paramount importance in patients with nonhealing anal fissures, fissures in atypical positions or with indurated or ulcerated anal tags and in patients with risk factors for the development of anal squamous intraepithelial lesions that are precursors of invasive anal squamous cell carcinoma. The authors present 3 cases of squamous cell carcinoma of the anus

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2016 GE Portuguese journal of gastroenterology

6. Topical Minoxidil Versus Topical Diltiazem for Chemical Sphincterotomy of Chronic Anal Fissure: A Prospective, Randomized, Double-Blind, Clinical Trial

Topical Minoxidil Versus Topical Diltiazem for Chemical Sphincterotomy of Chronic Anal Fissure: A Prospective, Randomized, Double-Blind, Clinical Trial Anal fissure is a common anorectal problem causing severe pain and discomfort to the patients. Chemical sphincterotomy has emerged as a noninvasive alternative to the surgical methods of fissure treatment. The objective of this study was evaluation of the efficacy and the adverse effects of topically applied minoxidil in chemical sphincterotomy (...) of chronic anal fissure in comparison with topical diltiazem.A total of 88 patients with chronic anal fissure aged between 15 and 65 years were included in this double-blind, randomized clinical trial and were randomly assigned to either 0.5% minoxidil cream or 2% diltiazem cream twice daily for 2 weeks. The pain intensity, bleeding, wound healing, itching, headache, dizziness, significant drop in blood pressure, allergy and fissure relapse were assessed on a monthly basis for 2 months.Both diltiazem

2018 EvidenceUpdates

7. Posterolateral versus lateral internal anal sphincterotomy in the treatment of chronic anal fissure: a randomized controlled trial. (PubMed)

Posterolateral versus lateral internal anal sphincterotomy in the treatment of chronic anal fissure: a randomized controlled trial. Lateral internal anal sphincterotomy (LIS) is considered the treatment of choice for chronic anal fissure. This study aimed to compare the outcome of standard LIS and posterolateral internal sphincterotomy (PLIS) at 5 o'clock position as regards healing of anal fissure, improvement in symptoms, and complications.Patients with chronic anal fissure were randomly (...) allocated to one of two groups; group I underwent PLIS and group II underwent LIS. Patients were compared regarding the duration of healing of anal fissure, improvement in anal pain as recorded by visual analogue scale (VAS), complications, particularly fecal incontinence (FI) and changes in the anal pressures.Eighty (49 females) patients were included to this trial. The mean age of patients was 35.5 years. The duration of healing was significantly shorter in group I than in group II (4.1 ± 1.7 vs 5.8

2018 International journal of colorectal disease

8. Anal advancement flap versus lateral internal sphincterotomy for chronic anal fissure- a systematic review and meta-analysis.

Anal advancement flap versus lateral internal sphincterotomy for chronic anal fissure- a systematic review and meta-analysis. Chronic anal fissures (CAF) are common and associated with reduced quality of life. Lateral internal sphincterotomy (LIS) is frequently carried out but carries a significant risk of anal incontinence. Anal advancement flap (AAF) has been advocated as an alternative, 'sphincter-preserving' procedure. We aimed to perform a systematic review and meta-analysis to compare (...) the efficacy of both techniques in the treatment of CAF.The online databases of PubMed/Medline, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials were searched from inception to January 2017. All studies that investigated and reported outcomes of LIS and AAF for treatment of CAF were included. The primary outcome measure was anal incontinence while secondary outcomes included unhealed fissure and wound complication rates. Random effects models were used to calculate pooled effect size

2018 International journal of surgery (London, England)

9. Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure

Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03426449 Recruitment Status : Completed First Posted : February 8, 2018 Last Update Posted : February 9, 2018 Sponsor: Mansoura University Information

2018 Clinical Trials

10. Anal self-massage in the treatment of acute anal fissure: a randomized prospective study (PubMed)

Anal self-massage in the treatment of acute anal fissure: a randomized prospective study An anal fissure (AF) is a tear in the epithelial lining of the anal canal. This is a very common condition, but the choice of treatment is unclear. The use of anal dilators is effective, economic, and safe. The aim of the study was to compare the efficacy of two conservative treatments, the use of anal dilators or a finger for anal dilatation, in reducing anal pressure and resolving anal fissures.Fifty (...) of their anal fissures. A comparison between signs and symptoms reported by the patients in the two groups showed a statistically significant reduction in anal pain (group A, P=0.0001; group B, P=0.0001) and bleeding after defecation (group A, P=0.001, group B, P=0.001). At 6 months after treatment, a significantly greater reduction in anal pain was observed in Group A compared to Group B (P=0.02).The use of anal self-massage with a finger appears to induce a better resolution of acute anal fissure than do

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2017 Annals of Gastroenterology

11. Lateral Anal Sphincterotomy for Chronic Anal Fissures- A Comparison of Outcomes and Complications under Local Anaesthesia Versus Spinal Anaesthesia (PubMed)

Lateral Anal Sphincterotomy for Chronic Anal Fissures- A Comparison of Outcomes and Complications under Local Anaesthesia Versus Spinal Anaesthesia 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.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.A total of 79 patients with chronic fissure underwent randomized allocation to two treatment arms - The first to undergo LAS under LA and the second under Spinal Anaesthesia (SA). The primary outcome variables studied were complications like post-operative

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2017 Journal of clinical and diagnostic research : JCDR

12. Efficacy of egg yolk and nitroglycerin ointment as treatments for acute anal fissures: A randomized clinical trial study. (PubMed)

Efficacy of egg yolk and nitroglycerin ointment as treatments for acute anal fissures: A randomized clinical trial study. Acute anal fissure as a common disease in society has several etiologies and manifestations such as severe anal pain and bleeding. Nitroglycerin ointment 0.2% is the most common topical treatment used. The most common side effect of nitroglycerin is headache, which is annoying for patients and often leads to discontinuation of the drug.Comparison of egg yolk as a natural (...) in the following days. Changes in the frequency of rectorrhagia were also significant in both groups, showing a major decrease in the number of rectorrhagia cases (p<0.001).Egg yolk is more efficient than nitroglycerin in the treatment of acute anal fissure. In addition, lack of any side effects results in the completion of the treatment course by the patients.The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015050718915N3.This work was supported

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2016 Electronic physician

13. Anal Fissure

Anal Fissure Anal Fissure in adults Anal Fissure in adults Anal Fissure in adults Anal Fissure in adults Management Management Management Management Options Options Options Options Brief Decision Aid Anal fissures are small tears of the skin of the anus, common in adults. Constipation and hard stools may cause them, and spasm of the anal muscles (sphincter) slows healing. Acute fissures have been present for less than six weeks; chronic fissures last longer than six weeks. There are three three (...) three three options in managing anal fissure: • General Measures General Measures General Measures General Measures – many fissures will heal on their own or with simple measures and ointments which ease the pain/inflammation and keep the faeces soft and easy to pass. • Calcium Channel Blocker and Nitrate ointment Calcium Channel Blocker and Nitrate ointment Calcium Channel Blocker and Nitrate ointment Calcium Channel Blocker and Nitrate ointments s s s - relax the muscles around the anus allowing

2015 SickKids Reports

14. Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure

Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure Sajid MS, Whitehouse PA, Sains P, Baig MK CRD summary The review concluded (...) that diltiazem and glyceryl trinitrate were equally effective in the initial healing of chronic anal fissure but diltiazem should be the preferred first line of treatment due to a lower incidence of headache and recurrent fissure. Notwithstanding some review limitations, these conclusions appear reasonable and the call for a further trial seems appropriate. Authors' objectives To compare diltiazem with glyceryl trinitrate for the non-surgical management of chronic anal fissure. Searching Cochrane Colorectal

2013 DARE.

15. [Acupoint catgut embedding therapy in treatment of anal fissure at â…  and â…¡ stages:a randomized controlled trial]. (PubMed)

[Acupoint catgut embedding therapy in treatment of anal fissure at â…  and â…¡ stages:a randomized controlled trial]. To evaluate the difference in the clinical therapeutic effects on anal fissure at Ⅰ and Ⅱ stages between the acupoint catgut embedding therapy and western medication.Sixty patients of anal fissure at Ⅰ and Ⅱ stages were randomized into an embedding therapy group and a western medication group, 30 cases in each one. In the embedding therapy group, the acupoint catgut embedding (...) weeks after treatment, the clinical therapeutic effects in the embedding therapy group were better than those in the western medication group (both P<0.05). In 3-month follow-up, the recurrent case in the embedding therapy group was one, and the recurrent case in the western medication group was six.The acupoint catgut embedding therapy is safe and effective in the treatment of anal fissure at Ⅰ and Ⅱ stages and its recurrent case is lower as compared with the treatment of western medication.

2018 Zhongguo zhen jiu = Chinese acupuncture & moxibustion

16. Effectiveness of 0.2% Glyceryl Trinitrate and 0.5% Nifedipine in the Treatment of Chronic Anal Fissure. (PubMed)

Effectiveness of 0.2% Glyceryl Trinitrate and 0.5% Nifedipine in the Treatment of Chronic Anal Fissure. 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.Ninety patients with symptomatic anal fissure in Kathmandu Medical College Teaching Hospital are allocated for study (...) using GTN in high percentage (16.6%) than complained by patients using topical Nifedipine (6.9%). This factor led to poor compliance with GTN compared with Nifedipine. Nifedipine showed better healing rate 82.5% compared with GTN 60%. Recurrence was comparable among the two groups.Nifedipine ointment showed better results than GTN ointment in chronic anal fissure regarding headache, compliance, healing and recurrence in 6 weeks of follow up period after complete healing of fissure in 8 weeks.

2018 JNMA; journal of the Nepal Medical Association

17. Comparison of Flavonoids and Centella asiatica for the treatment of chronic anal fissure. A randomized clinical trial. (PubMed)

Comparison of Flavonoids and Centella asiatica for the treatment of chronic anal fissure. A randomized clinical trial. We aim to test and compare the effects of Flavonoids (Fs) and Centella asiatica (Ca), and the traditional treatment to find out which best deals with healing time, bleeding and pain in the treatment of chronic Anal Fissure (AF). Materials of Study: 98 outpatients were divided randomly into treated (either Fs or Ca) and control group. The control group (Group C, n=32) received (...) with patients underwent to the traditional treatment.Anal bleeding, Anal fissure, Defecation pain.

2018 Annali italiani di chirurgia

18. Bilateral versus unilateral botulinum toxin injections for chronic anal fissure: a randomised trial (PubMed)

Bilateral versus unilateral botulinum toxin injections for chronic anal fissure: a randomised trial Botulinum toxin injected into the internal anal sphincter is used in the treatment of chronic anal fissure but there is no standardised technique for its administration. This randomised single centre trial compares bilateral (either side of fissure) to unilateral injection.Participants were randomised to receive bilateral (50 + 50 units) or unilateral (100 units) Dysport® injections (...) into the internal anal sphincter in an outpatient setting. Injection-related pain assessed by visual analogue scale was the primary outcome measure. Secondary outcomes were healing rate, fissure pain, incontinence, and global health scores.Between October 2008 and April 2012, 100 patients with chronic anal fissure were randomised to receive bilateral or unilateral injections. Injection-related pain was comparable in both groups. There was no difference in healing rate. Initially, there was greater improvement

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2018 Techniques in coloproctology

19. Comment on: Botulinum toxin injection vs topical nitrates for chronic anal fissure: an updated systematic review and meta-analysis of randomized controlled trials.

Comment on: Botulinum toxin injection vs topical nitrates for chronic anal fissure: an updated systematic review and meta-analysis of randomized controlled trials. 29509330 2019 01 21 2019 01 21 1463-1318 20 5 2018 05 Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland Colorectal Dis Comment on: Botulinum toxin injection vs topical nitrates for chronic anal fissure: an updated systematic review and meta-analysis of randomized controlled (...) trials. 451 10.1111/codi.14063 Granger S S Department of Colorectal Surgery, Cheltenham General Hospital, Gloucestershire Hospitals NHS FT, Cheltenham, UK. Glancy D D Department of Colorectal Surgery, Cheltenham General Hospital, Gloucestershire Hospitals NHS FT, Cheltenham, UK. eng Letter Comment England Colorectal Dis 100883611 1462-8910 0 Nitrates EC 3.4.24.69 Botulinum Toxins IM Colorectal Dis. 2018 Jan;20(1):6-15 29166553 Colorectal Dis. 2018 May;20(5):451-452 29573107 Botulinum Toxins Fissure

2018 Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

20. Topical Minoxidil Versus Topical Glyceryl Trinitrate in Treatment of Chronic Anal Fissure

Topical Minoxidil Versus Topical Glyceryl Trinitrate in Treatment of Chronic Anal Fissure Topical Minoxidil Versus Topical Glyceryl Trinitrate in Treatment of Chronic Anal Fissure - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more (...) studies before adding more. Topical Minoxidil Versus Topical Glyceryl Trinitrate in Treatment of Chronic Anal Fissure The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03528772 Recruitment Status : Recruiting First Posted

2018 Clinical Trials

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