- Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis. [Journal Article]
- CDCochrane Database Syst Rev 2019 05 28; 5:CD001176
- CONCLUSIONS: The effects of antibiotics, probiotics and other interventions for treating and preventing pouchitis are uncertain. Well designed, adequately powered studies are needed to determine the optimal therapy for the treatment and prevention of pouchitis.
- Prevalence and characterization of breakthrough pain in cancer patients with proctalgia treated with 3D pelvic radiotherapy. [Journal Article]
- CTClin Transl Oncol 2019 Apr 05
- CONCLUSIONS: This study demonstrated a high prevalence of BTcP prevalence in cancer patients undergoing pelvic 3D radiotherapy and with proctalgia. Although the variables determining the onset of BTcP are still unclear, our results could help in the design of future clinical studies addressing the treatment of BTcP in these patients.
- Efficacy of Injection of Freshly Collected Autologous Adipose Tissue Into Perianal Fistulas in Patients With Crohn's Disease. [Randomized Controlled Trial]
- GGastroenterology 2019; 156(8):2208-2216.e1
- CONCLUSIONS: In a study of 21 patients with CD and perianal fistulas, we found injection of recently collected autologous adipose tissue to be safe and to result in complete fistula healing in 57% of patients. ClinicalTrials.gov, Number: NCT03803917.
- Proctalgia and constipation secondary to hypertrophic polyglucosan inclusion body myopathy of the internal anal sphincter: a case report. [Case Reports]
- JMJ Med Case Rep 2018 Oct 24; 12(1):315
- CONCLUSIONS: Hereditary polyglucosan inclusion body myopathy of the internal anal sphincter should be considered in the differential diagnosis of a patient presenting with severe anal pain and constipation in the absence of an anal fissure or sepsis. If medical therapy with calcium antagonists fails to provide symptom relief, lateral internal sphincterotomy should be considered rather than botulinum toxin injection.
- Management of Common Benign Anorectal Disease: What All Physicians Need to Know. [Review]
- AJAm J Med 2018; 131(7):745-751
- Benign anorectal conditions produce anal pain, rectal bleeding, or discharge from the perianal region, which are highly prevalent symptoms in the general population. Hemorrhoidal disease, anal fissur…
Benign anorectal conditions produce anal pain, rectal bleeding, or discharge from the perianal region, which are highly prevalent symptoms in the general population. Hemorrhoidal disease, anal fissure, perianal abscess, proctalgia syndromes, and pruritus anii are the most common clinical disorders. Well-trained physicians, irrespective of their specialty, can treat most of these disorders and refer them to a specialist in proctology only when necessary. The aim of this review is to provide a practical guide to the management of benign anorectal disorders in terms of their initial management and the criteria for specialist referral.
- Metachronous metastatic colonic small cell carcinoma and recurrent adenocarcinoma in a patient with ulcerative colitis. [Case Reports]
- JSJ Surg Case Rep 2017; 2017(10):rjx201
- Colonic small cell carcinomas (SCCs) are rare, aggressive tumors characterized by early metastasis and poor prognosis. We describe a 39-year-old man with a history of ulcerative colitis and left colo…
Colonic small cell carcinomas (SCCs) are rare, aggressive tumors characterized by early metastasis and poor prognosis. We describe a 39-year-old man with a history of ulcerative colitis and left colon adenocarcinoma resected at an outside institution who presented with hematochezia and proctalgia. Work-up revealed left colon SCC with liver metastases. After his excellent response to neoadjuvant chemotherapy, we performed synchronous proctocolectomy and right hepatectomy. Final pathologic evaluation revealed colonic primary SCC and recurrent adenocarcinoma with metastatic SCC to the liver; lymph nodes were positive for metastatic SCC and adenocarcinoma. SCC recurrence ultimately developed in the liver. To the best of our knowledge, this is the second reported case of surgical management of SCC of the colon with liver metastasis and the first report of synchronous excision. Despite superb response to neoadjuvant therapy and young patient age, caution is needed in surgical resection for SCC of the colon given the high recurrence risk.
- Sleep quality and functional gastrointestinal disorders. A psychological issue. [Journal Article]
- JDJ Dig Dis 2018; 19(2):84-92
- CONCLUSIONS: Sleep disorders are associated with FGIDs, especially in the presence of depressive symptoms.
- Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals. [Journal Article]
- CECir Esp 2018; 96(1):18-24
- CONCLUSIONS: The management of FAC in Spain shows similarities with the international guideline suggestions. Nevertheless, some differences can be seen from the first stages of treatment.
- Use of botulinum A toxin for proctalgia fugax-a case report of successful treatment. [Case Reports]
- JSJ Surg Case Rep 2017; 2017(11):rjx236
- Proctalgia fugax is considered as intermittent anal pain of unknown etiology; a variety of treatments have been used, without, however, permanent results. Injection of botulinum A toxin is recently s…
Proctalgia fugax is considered as intermittent anal pain of unknown etiology; a variety of treatments have been used, without, however, permanent results. Injection of botulinum A toxin is recently suggested as an alternative option. We present the case of a woman presenting proctalgia fugax that was untreatable through other current forms of treatment. After two administrations of botulinum A toxin, 80 units and 100 units each, the patient remained asymptomatic on 8-month follow-up control. Botulinum A toxin injection can reduce internal anal sphincter pressure, leading to relief of symptoms, and seems a promising option with minimal morbidity in cases on proctalgia fugax that does not respond to other current treatments.
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- Diagnosis and Management of Anorectal Disorders in the Primary Care Setting. [Review]
- PCPrim Care 2017; 44(4):709-720
- Anorectal disorders are very common among a wide population of patients. Because patients may be embarrassed about the anatomic location of their symptoms, they may present to care late in the course…
Anorectal disorders are very common among a wide population of patients. Because patients may be embarrassed about the anatomic location of their symptoms, they may present to care late in the course of their illness. Care should be taken to validate patient concerns and normalize fears. This article discusses the diagnoses and management of common anorectal disorders among patients presenting to a primary care physician.