Expert Commentary on Anal Fissure

Expert Commentary on Anal Fissure 296 STEINHAGEN: ANAL FISSURE RESIDENT'S CORNER Kim Champion Lu, M.D. Portland, Oregon r Steinhagen has succinctly reviewed the diag- appreciated by patients, especially if applied just before nosis and management of anal fissures, one of a bowel movement. Dr Steinhagen’s algorithm allows for Dthe most common reasons for a person to visit a either topical calcium channel blockers or nitrates as the colorectal surgeon. Although isolated anal pain or bleed- topical medical therapy. Off-label use of diltiazem com- ing with defecation might be ignored by many patients, pounded to a 2% ointment or gel has lower cost and fewer with both pain and bleeding, many patients seek medi- headaches than topical nitroglycerin. Instructing the pa- cal evaluation. For some, the severity of this pain can ri- tient to use a glove or even plastic wrap over the finger will val that of childbirth and ureterolithiasis, whereas others limit absorption through the finger. For refractory fissures, Dr Steinhagen’s algorithm in- have milder symptoms and want to be reassured that they do not have cancer. cludes lateral internal sphincterotomy (LIS) or off-label History is key to the diagnosis. The most common use of botulinum toxin (Botox) without preference. I find that http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Diseases of the Colon & Rectum Wolters Kluwer Health

Expert Commentary on Anal Fissure

Loading next page...
 
/lp/wolters_kluwer/expert-commentary-on-anal-fissure-A0ltMiPksN
Publisher
Wolters Kluwer
Copyright
© The ASCRS 2018
ISSN
0012-3706
eISSN
1530-0358
D.O.I.
10.1097/DCR.0000000000001043
Publisher site
See Article on Publisher Site

Abstract

296 STEINHAGEN: ANAL FISSURE RESIDENT'S CORNER Kim Champion Lu, M.D. Portland, Oregon r Steinhagen has succinctly reviewed the diag- appreciated by patients, especially if applied just before nosis and management of anal fissures, one of a bowel movement. Dr Steinhagen’s algorithm allows for Dthe most common reasons for a person to visit a either topical calcium channel blockers or nitrates as the colorectal surgeon. Although isolated anal pain or bleed- topical medical therapy. Off-label use of diltiazem com- ing with defecation might be ignored by many patients, pounded to a 2% ointment or gel has lower cost and fewer with both pain and bleeding, many patients seek medi- headaches than topical nitroglycerin. Instructing the pa- cal evaluation. For some, the severity of this pain can ri- tient to use a glove or even plastic wrap over the finger will val that of childbirth and ureterolithiasis, whereas others limit absorption through the finger. For refractory fissures, Dr Steinhagen’s algorithm in- have milder symptoms and want to be reassured that they do not have cancer. cludes lateral internal sphincterotomy (LIS) or off-label History is key to the diagnosis. The most common use of botulinum toxin (Botox) without preference. I find that

Journal

Diseases of the Colon & RectumWolters Kluwer Health

Published: Mar 1, 2018

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off