In the short-to-medium term, both techniques are safe and equally effective. The results justify continued research into the use of biomaterials to heal anal fistulae.
This article deals with psychological contributions, such as stool withholding or responses to abuse experiences, to the aetiology of evacuation disorders (with a focus on dyssynergic defecation), and with education and behavioural approaches to treatment.
A bulking agent and Nurse led education, advice and bowel habit retraining is as effective in reducing the incidence of bleeding from 1st and 2nd degree haemorrhoids as injection sclerotherapy. Patients who consult a NP with symptomatic 1st and 2nd degree haemorrhoids feel more empowered in the long term. Non-invasive bowel retraining methods should be offered as an alternative to more traditional, invasive treatments for patients with symptomatic early hemorrhoidal disease.
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