Anal fissures

Anal fissures; first do no harm.

emergency centre staffed with GPs, nurse practitioners, and emergency medicine doctors. Handover between OOH and in-hours GPs has been defined as ‘one of the most perilous procedures in medicine, and when carried out improperly can be a major contributory factor to subsequent error and harm to patients’.1 In-hours care accounts for 50 hours/week while OOH care accounts for 118 hours/week. Hando...

Anal fissures associated with targeted therapies in ovarian cancer.

Although ovarian cancer remains a leading cause of gynecologic cancer death, targeted therapies are improving patient outcomes. Anal fissures are a side effect of targeted therapies that can disrupt or stop treatment regimens. Diagnosis and management of anal fissures by advanced practice nurses are crucial for maintaining the quality of life of patients with ovarian cancer.

Clinical Practice Guideline for the Management of Anal Fissures.

Neuromyogenic properties of the internal anal sphincter: therapeutic rationale for anal fissures.

Lateral sphincterotomy diminishes internal anal sphincter hypertonia and thereby reduces anal canal pressure. This improves anal mucosal blood flow and promotes the healing of anal fissures. However, sphincterotomy can be associated with long term disturbances of sphincter function. The optimal treatment for an anal fissure is to induce a temporary reduction of anal canal resting pressure to al...

Neuromyogenic Properties of the Internal Anal Sphincter: Applications for the Treatment of Anal Fissures

Pharmacological therapy of anal fissures reduces maximum resting pressure (MRP), allowing healing by promoting anodermal vascular perfusion. In this thesis the clinical and manometric responses to diltiazem and botulinum toxin and the therapeutic potential of indoramin and salbutamol were investigated. A porcine internal anal sphincter model was developed to validate the responses to pharmacolo...