Anal fissure

Schlichtemeier, Steven; Engel, Alexander

doi:10.18773/austprescr.2016.007

Cited by 38 publications

(49 citation statements)

References 21 publications

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“…) . The exact aetiology for chronic anal fissure is unknown; however, the most commonly accepted theory is ischaemia . There are small numbers of recent observational studies that challenge the idea that chronic anal fissure is due to ischaemic ulceration .…”

Section: Introductionmentioning

confidence: 99%

Combined treatment approach to chronic anal fissure with associated anal fistula

FitzDowse

Behrenbruch

Hayes

2017

ANZ Journal of Surgery

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Section: Introductionmentioning

confidence: 99%

Combined treatment approach to chronic anal fissure with associated anal fistula

FitzDowse

Behrenbruch

Hayes

2017

ANZ Journal of Surgery

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“…3,15 It is very important to note that anorectal disorders like anal fissures and hemorrhoids are not only the etiology but also the complications of untreated constipation. 15,16 To address this vicious cycle, timely intervention is of utmost importance. Early treatment with laxatives relieves the straining at stools and helps patients in improving their QoL.…”

Section: Discussionmentioning

confidence: 99%

“…In patients who had already developed these complications, straining further increases the risk of worsening of symptoms with bleeding and pain during defecation which lead to poor QoL. 15,16 Therapy with milk of magnesia, liquid paraffin and sodium picosulphate showed significant improvement in stool frequency, stool consistency and straining, which translated into an improvement in QoL in these patients (reduction in PAC-QOL score by 43.13%, p< 0.0001 compared to baseline).…”

Section: Discussionmentioning

confidence: 99%

A prospective non-comparative study to assess the effectiveness and safety of combination laxative therapy containing milk of magnesia, liquid paraffin and sodium picosulphate (Cremaffin-Plus®) in the management of constipation in patients with anal fissure/hemorrhoids/obstructive defecation syndrome

Patankar

Mishra

2017

Int Surg J

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Background: Assess the effectiveness and safety of combination laxative therapy containing milk of magnesia, liquid paraffin and sodium picosulphate (Cremaffin-Plus®) in management of constipation, in patients with anal fissure/haemorrhoids/obstructive defecation syndrome (ODS). Methods: Patients visiting study site with complaints of constipation secondary to anal fissures/haemorrhoids/ODS, intended to receive combination laxative therapy (as per physicians' discretion), were enrolled. Primary objectives were to assess the change in number of bowel movements per day and stool consistency; secondary objectives were to assess change in straining, physician global efficacy assessment, quality of life (PAC-QOL score), Constipation Symptoms (CSS), Fecal Incontinence Score (FIS), Patient Assessment of Constipation Symptoms (PAC-SYM) score, along with the Modified Longo Score (MODS) for ODS from baseline to end of 4 weeks. Safety, tolerability and treatment adherence were also assessed. Results: About 32 patients (anal fissure:19, haemorrhoids:5, ODS:8) met inclusion criteria. Significant improvement in stool frequency was observed in all patients pooled together (p=0.016); group wise, statistical significance was noted in patients of anal fissures. Stool consistency was improved in all patients pooled together (p<0.001); group wise, significant improvement was seen in patients of anal fissure and ODS. There was a significant improvement in straining noted in all patients pooled together (p=0.002). Significant reduction (p<0.001) was noted in all the symptom scores (CSS, FIS, PAC-SYM and PAC-QOL) from baseline to 4 weeks in all patients. About 51.44% reduction in MODS score was noted in patients with ODS. Conclusions: Improvement in stool frequency, consistency and straining was noted in all patients with constipation (with fissure/haemorrhoids/ODS) treated with Cremaffin-plus for 4-weeks, improving the quality of life. All patients showed good therapy adherence with better safety and tolerability profile.

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“…The pathological process with acute and chronic AF is characterized by a set of typical symptoms (inflammation, pain, microcirculatory vascular disorders and dysfunction of the sphincter apparatus) that develop simultaneously. One of the most important pathogenetic mechanisms that lead to tissue ischemia in the AF localization zone is the persistent spasm of the internal anal sphincter [1,4].…”

Section: Pharmacology Toxicology and Pharmaceutical Sciencementioning

confidence: 99%

“…Anal fissure (AF) is one of the most common anorectal problems [1,2]. According to various authors, the proportion of patients with AF in the structure of colorectal disease is from 8.5 to 16.0 %, women suffer from 1.5 to 2.0 times more often than men [3].…”

Section: Introductionmentioning

confidence: 99%

Experimental Approval of the Efficacy of the Combined Composition Rectal Cream New Test-Samples in the Conditions of Acute Complicated Anal Fissure in Rats

Zaychenko

Stakhorska

2019

EUREKA: Health Sciences

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Anal fissure (AF) is one of the most common anorectal problems. The severity of the disease, the chronicity of the pathological process and frequent complications lead to a sharp deterioration in the quality of life of patients. An important place in the treatment of anal fissure is occupied by drugs that affect its key mechanism of pathogenesis, namely, reduce the muscle tone of the internal anal sphincter and have anti-inflammatory, analgesic, and reparative properties. Aim: conducting of screening studies of the effectiveness of new test samples of rectal cream of the combined composition (RCCC) on the model of acute complicated anal fissure in rats and determining the optimal composition of the potential drug. Materials and methods. The research was conducted on the basis of the Central Scientific Research Laboratory of the National Pharmaceutical University (CSRL NUPH) in the spring (April) season of 2015 on the female rats. A study of test specimens of the rectal cream of the combined composition was performed on a modified model of acute anal fissure. The effectiveness of the treatment was evaluated in terms of (0 to 2) severity of edema, hyperaemia, local bleeding, purulent necrotic processes, scapular formation, anatomical defect, and a general indicator of the severity of the pathological process (by the sum of the points for all the criteria that were analyzed). The level of proinflammatory PGE2 in serum was determined by the immune enzyme method. Results. The RCCC sample No. 4 showed the most expressive therapeutic effect among the four samples under study, and had credible benefits to the inhibitory effect on purulent-necrotic processes, as expressed by the differences in the overall rate of the pathological process (6 days: 5.83±0.47 points against 7.00±0.37; 7.83±0.31 under the influence of RCCC No. 2, No. 3, respectively, and for 11 days 5.00±1.03 versus 6.83±1.28 points (p=0.08) under the influence of RCCC No. 1). The ability of RCCCs No. 1 and No. 4 to reduce the level of pro-inflammatory PGE2 in blood serum of rats compared with CP in 1.8 and 2.0 times, respectively, contributed to accelerating epithelization and scar formation. The advantages of RCCC No. 4 on the comparison of the ointment "Proctozan" with the reduction of the period of epithelization of the defect of the mucous membrane of the anal canal for 3 days (for 7 days-RCCC No. 4, for 10 days-ointment "Proctozan"). Conclusions. The rectal cream of the combined composition No. 4 showed the greatest efficacy, had advantages over the comparison ointment "Proctozan", and is promising for the creation on its basis a new drug for the treatment of anal fissures.

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Anal fissure

Cited by 38 publications

References 21 publications

Combined treatment approach to chronic anal fissure with associated anal fistula

Combined treatment approach to chronic anal fissure with associated anal fistula

Experimental Approval of the Efficacy of the Combined Composition Rectal Cream New Test-Samples in the Conditions of Acute Complicated Anal Fissure in Rats

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