Haemorrhoids are a chronic disease of the anorectal area characterised by pain, bleeding and discomfort, which significantly reduce the quality of life of patients, limiting their physical activity, emotional state and social interactions, especially in cases requiring surgery. Despite significant progress in surgical treatment methods, the impact of these methods on the quality of life of patients remains insufficiently studied. The study aimed to determine the impact of haemorrhoids and their surgical treatment on the quality of life of patients. The study involved 634 patients, most of whom were women (76.5%). Participants were divided by age group, professional activity and place of residence. A modified sociological questionnaire was used to assess the physical, emotional and social aspects of respondents' lives. The results of the study demonstrated that, in most cases, the quality of life of patients improved significantly after surgery: most respondents reported no significant limitations in physical activity, and it did not cause significant discomfort in 88% of cases, although moderate or mild pain persisted in 46% of patients. The findings demonstrate that timely surgical treatment of haemorrhoids has a positive impact on the quality of life of patients, reducing pain symptoms and improving their general condition. The practical significance of the study is determined by the possibility of using its results to improve approaches to the treatment and rehabilitation of patients with haemorrhoids, as well as to introduce standards for assessing the quality of life of patients with haemorrhoids to optimise therapy.

Women are disproportionately affected by disorders of gut-brain interaction (DGBI), including esophageal, gastroduodenal, bowel, and anorectal conditions, and frequently experience overlapping pain syndromes. This review synthesizes clinical and preclinical evidence on sex- and gender-related differences in DGBI, highlighting alterations in central pain processing, autonomic regulation, stress, microbiota composition, epithelial permeability, motility, genetic and epigenetic factors, and immune responses that may underlie observed disparities. Emerging data indicate that gonadal hormones, interacting with environmental stressors across the lifespan, modulate symptom severity and disease course. Social determinants of health, inadequate patient-provider communication, and disorder-associated stigma further exacerbate inequities in diagnosis and care. Research remains limited by lack of standardized definitions of sex and gender, under-representation of men and gender minorities, and insufficient consideration of hormonal changes and exogenous hormone exposure. Addressing these gaps is essential to advance our understanding of DGBI and guide gender-informed diagnostic and therapeutic strategies for DGBI management.

Esophageal atresia (EA) is a rare congenital anomaly characterized by esophageal discontinuity, frequently associated with tracheoesophageal fistula (TEF) and other congenital malformations. Advances in neonatal surgery, perioperative care, and critical care have substantially improved survival, shifting the focus to neurodevelopmental outcomes, long-term health, and quality of life-topics explored in this review. We summarize findings from original prospective and retrospective studies examining developmental trajectories, psychosocial outcomes, and quality of life. This review aims to (1) support informed clinical counseling and physician-family communication, (2) guide multidisciplinary and lifelong follow-up, and (3) identify knowledge gaps that warrant more systematic, longitudinal, and multicenter investigation to optimize outcomes for children born with EA.

A 41-year-old female with a past medical history of depression, anxiety, intravenous drug use, and opioid use disorder (OUD) presented to the emergency department in December with frostbite of her bilateral hands and feet after living outside. She was found to have a left brachial artery occlusion and underwent embolectomy the next day. Her 51-day hospital course was subsequently complicated by an ST-elevation myocardial infarction, heart failure with reduced ejection fraction, stroke, right brachial vein deep vein thrombosis, pyelonephritis, acute hypoxic respiratory failure, and a new diagnosis of stage IV vulvar and anorectal squamous cell carcinoma, necessitating ostomy placement. Her frostbite also led to significant debility of her legs. The patient had a 20-year history of using opioids, and at the time of index admission, smoked 1 gm of fentanyl daily. Throughout her hospital course, the Addiction Medicine, Palliative Care, Psychiatry, Gynecologic Oncology, Cardiology, and General Medicine teams collaborated to manage her pain, cravings, and withdrawal, and to coordinate care in the setting of multiple comorbidities. For OUD and pain, she was initially started on methadone, then switched to buprenorphine due to prolonged QTc, and discharged when stable. However, she relapsed on fentanyl during her time out of the hospital, and upon readmission was ultimately switched back to methadone through close coordination with all teams, including Cardiology. The patient was stabilized on a regimen of methadone, gabapentin, and duloxetine, with several other medications tried and provided as needed for pain management throughout her admissions. Her medical teams also advocated to the hospital leadership to allow her to remain inpatient for her radiation therapy, given her insecure housing situation; she ultimately completed all radiation and chemotherapy treatments. Particularly given that guidance for the management of OUD in patients with advanced cancer is relatively nascent, this case demonstrates innovative, multidisciplinary management of a patient with significant medical and psychiatric complexity, multiple pain syndromes, and successful completion of inpatient cancer treatment in a patient with OUD and housing insecurity.

Low anal fistula is a common anorectal disorder and fistulectomy and fistulotomy are frequently used surgical treatments. Therefore, it is of interest to evaluate the clinical outcomes, complications and recurrence rates between these two approaches in 120 patients with low anal fistula. Patients were randomly divided into two groups, with 60 undergoing fistulectomy and 60 undergoing fistulotomy. The study found that fistulotomy had significantly lower operative times, postoperative pain and faster wound healing compared to fistulectomy. There was no significant difference in recurrence or continence between the two groups. Fistulotomy proved to be a simpler, quicker and less painful procedure, making it the preferred option in selected cases.