The management of anal fissure: ACPGBI position statement
| Autor: | E. J. D. Massey, K. L. R. Cross, J. R. T. Monson, A. L. Fowler |
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| Rok vydání: | 2008 |
| Předmět: |
Position statement
Male medicine.medical_specialty Anal fissure Evidence-Based Medicine Linear ulcer business.industry Gastroenterology Anal canal medicine.disease Botulinum toxin Internal anal sphincter Surgery medicine.anatomical_structure Clinical Protocols Anesthesia medicine Humans Female Fissure in Ano business medicine.drug |
| Zdroj: | Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 10 |
| ISSN: | 1463-1318 |
| Popis: | Anal fissure is a linear ulcer in the squamous epithelium ofthe anal canal located just distal to the dentate line. It isusually located in the posterior midline but occursanteriorly in a fifth or more or patients. It typically causespain during defaecation which may last for 1–2 hafterwards [1]. The most consistent finding on physicalexamination is spasm of the anal canal due to hypertoniaof the internal anal sphincter. It has been postulatedthat this may either be due to or be the result ofischaemia [2]. All management options aim to reduceanal tone. They include general measures such as dietaryfibre supplements, adequate fluid intake, and topicalanalgesics, medical treatments such as glyceryl trini-trate(GTN) ointment, calcium channel blockers (egdiltiazem cream) and botulinum toxin. Surgery includeslateral sphincterotomy, advancement flap procedures andfissurectomy. This position statement recommendsevidence-based practice associated with these treatmentoptions. |
| Databáze: | OpenAIRE |
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