Some mixed hyperplastic adenomatous polyps (MHAPs) contain dysplastic lesions or even carcinomas. These polyps are considered to be different from ordinary hyperplastic polyps and may have a preneoplastic potential. We investigated APC and K-ras mutations in MHAPs of the colon and rectum, and also in colorectal adenomas and hyperplastic polyps to identify molecular differences between MHAPs, adenomas and hyperplastic polyps, using direct sequencing of mutation cluster regions (MCR) in APC and K-ras. No APC mutations were identified in 12 MHAPs and 8 hyperplastic polyps, whereas 10 of 27 (37.0%) adenomas showed somatic mutations. K-ras mutations were identified in one of 12 (8.3%) MHAPs, one of 8 (12.5%) hyperplastic polyps, and 10 of 27 (37.0%) adenomas. p53 mutation was found in a carcinoma arising in an MHAP. Mutations other than APC mutations may play a role in the development of MHAPs.

Summary Background  A treatment approach for patients with haemorrhoidal disease and other anal disease, which includes the use of topical corticosteroids and other topical combination products, is widely accepted, but little has been published to compare such treatments. This publication is a valuable collection of reading material for gastroenterologists, proctologists, general practitioners, dermatologists and other clinicians who are responsible for diagnosing and managing patients with haemorrhoidal disease. Aims  To review and collect existing treatment approaches for haemorrhoidal disease, by reviewing global experience from clinicians that will contribute towards improving best practice in the management of patients. Methods  The articles include overviews of haemorrhoidal disease, differential diagnosis, topical treatment and surgical practices and patient outcomes. Case studies further reinforce treatments from individual specialists. Results  The articles between them address the classification of haemorrhoids, dermatological differential diagnoses of anal and perianal disease, and the therapeutic management of different haemorrhoidal diseases including invasive surgical and non‐invasive topical combination treatments. The case studies indicate the positive impact of appropriate treatment in everyday clinical practice. Conclusion  This publication will reinforce best practice in the causative and symptomatic treatment of haemorrhoidal disease. Aliment Pharmacol Ther 31 (Suppl. 1), 1–58

For patients undergoing incision and drainage of anorectal abscesses, obesity did not affect recurrence. Prompt incision of anorectal abscesses was important to avoid recurrence.

At the posterior wall, a late period hemorrhage is less likely to be found than an early period hemorrhage. It was found that the more piles that were excised, the greater the occurrence of PH.

Among patients with hemorrhoids receiving AT, ALTA injection sclerotherapy is recommended for those in whom it is difficult to discontinue AT.