Benign anorectal disease: hemorrhoids, fissures, and fistulas

Gardner, Ivy H.; Siddharthan, Ragavan; Tsikitis, Vassiliki L.

doi:10.20524/aog.2019.0438

Cited by 34 publications

(45 citation statements)

References 80 publications

(141 reference statements)

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“…Anoac-H suppresses the cell migratory potential. Several cell types infiltrate the site of hemorrhoids and fistula to induce an inflammatory reaction (8,15,(20)(21)(22). Several cell types, including macrophages and fibroblasts, migrate to the site of inflammation and have a critical role in the inflammatory reaction (20)(21)(22).…”

Section: Effect Of Anoac-h On Cell Viabilitymentioning

confidence: 99%

“…Hemorrhoids and fistulas are associated with inflammation. Different types of cells, such as macrophages, neutrophils, and fibroblasts, are present in the inflammatory environment of hemorrhoids and fistulas (8,15,(20)(21)(22). Natural remedies for hemorrhoids and fistula, including laxatives, analgesics and anti-inflammatory agents, have drawn much attention recently due to their relatively higher effectiveness, low cost and lower invasiveness (23,24).…”

Section: Introductionmentioning

confidence: 99%

“…Classic anal fistulas are the outcome of a perineal infection and abscess formation ( 14 ). Fistulas are also associated with inflammatory bowel disease, Crohn's disease, radiation, malignancy, chronic diarrhea or pre-existing incontinence ( 15 ). Expression of RANTES and VEGF is observed in Crohn's disease-related perianal fistula and arteriovenous fistulas ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

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Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Porwal¹,

Kundu

Bhagwat³

et al. 2021

Mol Med Rep

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Hemorrhoids and fistula are considered the most common anorectal conditions in the general population. These conditions affect the quality of a patient's life by causing pain and bleeding during defecation or even in the resting state. Lower grades of hemorrhoids may be controlled by traditional measures. However, surgery is an effective treatment option in recurrent-lower and higher-grade hemorrhoids. Surgical procedures are associated with various complications, including pain and delayed wound healing. Recurrence of hemorrhoids is also a major concern in the post-operative period. An anal fistula is the connection between the anus and the skin and causes severe pain, swelling, as well as blood and pus discharge. Fistula has serious social and economic consequences. Hence, it is important to understand the pathophysiology and molecular pathology of hemorrhoids and fistula, to identify the molecular targets and to develop pharmacological-interventions. In a previous study by our group, the polyherbal formulation Anoac-H was developed for the treatment of different stages of hemorrhoids and fistula, and it was demonstrated that Anoac-H is an effective formulation for treating hemorrhoids. However, the molecular mode of action of Anoac-H on hemorrhoids and fistula had remained elusive. In the present study, it was determined that this formulation reduces the migration of mesenchymal (fibroblasts) and immune (RAW 264.7) cells without affecting their viability. It was also observed that Anoac-H suppresses the expression of regulated upon activation, normal T cell expressed and presumably secreted (RANTES) and VEGF in fibroblasts and macrophages. Inflammation and elevated expression of RANTES and VEGF were observed in hemorrhoids and fistula. However, inflammation, as well as the expression of RANTES and VEGF, were significantly reduced in treated human hemorrhoid and fistula tissues as compared to untreated ones, confirming the in vitro results.

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Section: Effect Of Anoac-h On Cell Viabilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Porwal¹,

Kundu

Bhagwat³

et al. 2021

Mol Med Rep

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show abstract

“…Treatment aims to heal the anal fissure, rather than using specific hemostasis techniques. Management of anal fissures begins with conservative treatment involving stool softeners, fiber supplementation, sitz baths, and topical lidocaine gel for pain relief (Gardner et al, 2020). Surgical treatment is preferred in chronic fissures.…”

Section: Anal Fissures Bleedingmentioning

confidence: 99%

Lower Gastrointestinal Bleeding

Öcal¹,

Çatli²

2021

J Exp Clin Med

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Bleeding from the lower part of the digestive system that appears as hematochezia (fresh blood, clot or cherry-coloured stool) or melena (dark-coloured tarry stool) is called lower gastrointestinal tract bleeding (lower GI bleeding) (or colonic bleeding). In the traditional definition, lower GI bleeding was generally classified as bleeding distal to the Treitz ligament (duodenojejunal junction) as the border. In the last decade, GI bleeding has adopted three categories in some recent publications: Upper, middle, and lower. According to this category, bleeding from a source between the Treitz ligament and the ileocecal valve is classified as middle GI bleeding, bleeding from the distal of the ileocecal valve is classified lower GI bleeding. Lower GI bleeding and hospitalization rates increase with ageing. Currently, physicians managing lower GI bleeding have many different diagnostics and therapeutic options ranging from colonoscopy and flexible sigmoidoscopy to radiographic interventions such as scintigraphy or angiography. Lower GI bleeding often stops spontaneously and less common than upper GI bleeding. Even though no modality has emerged as the gold standard in the treatment of lower GI bleeding, colonoscopy has several advantages and is generally considered as the preferred initial test in most of the cases.

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“… 52 The standard management is surgical treatment, including fistulotomy with or without seton placement, fibrin plug, ligation of intersphincteric fistula tract, and endorectal advancement flap. 53 A delay in the treatment of anal fistula is expected during the COVID-19 pandemic and will increase, to the discomfort of patients. Outpatient exploration with proctoscopy, and seton placement, are options based on a previous study in Crohn’s disease patients.…”

Section: Anal Fistulamentioning

confidence: 99%

Insights into the management of anorectal disease in the coronavirus 2019 disease era

Amjad

Haider

Malik

et al. 2021

Therap Adv Gastroenterol

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Coronavirus 2019 disease (COVID-19) has created major impacts on public health. The virus has plagued a large population requiring hospitalization and resource utilization. Knowledge about the COVID-19 virus continues to grow. It can commonly present with gastrointestinal symptoms; initially, this was considered an atypical presentation, which led to delays in care. The pandemic has posed serious threats to the care of anorectal diseases. Urgent surgeries have been delayed, and the care of cancer patients and cancer screenings disrupted. This had added to patient discomfort and the adverse outcomes on healthcare will continue into the future. The better availability of personal protective equipment to providers and standard checklist protocols in operating rooms can help minimize healthcare-related spread of the virus. Telehealth, outpatient procedures, and biochemical tumor marker tests can help with mitigation of anorectal-disease-related problems. There is limited literature about the clinical management of anorectal diseases during the pandemic. We performed a detailed literature review to guide clinicians around management options for anorectal disease patients. We also highlighted the health challenges seen during the pandemic.

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Benign anorectal disease: hemorrhoids, fissures, and fistulas

Cited by 34 publications

References 80 publications

Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Lower Gastrointestinal Bleeding

Insights into the management of anorectal disease in the coronavirus 2019 disease era

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