Funktionelle Pathomechanismen der Analfissur

Jostarndt, L.; Nitsche, D.; Löhnert, M.; Albers, Ulrike; Hamelmann, H.

doi:10.1007/bf01273848

Cited by 4 publications

(2 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most studies have demonstrated high resting anal pressure in patients with chronic anal fissure [ 133–135] with at least a short‐term reduction in anal pressure following lateral sphincterotomy [ 136]. Many studies however have failed to show a sustained long‐term reduction in anal hypertonia after this procedure despite clinical fissure healing, suggesting that IAS spasm rather than any functional constitutive hypertonia is more a result rather than a cause of the fissure itself [ 137, 138]. These changes have been coupled with abnormal RAIR in patients with chronic fissures, frequently associated with longer high pressure zone length at rest along with variation in the duration and extent of the inhibitory curve [ 139–142].…”

Section: The Role Of the Ias In Specific Anorectal Diseasementioning

confidence: 99%

The importance of the internal anal sphincter (IAS) in maintaining continence: anatomical, physiological and pharmacological considerations

et al. 2000

View full text Add to dashboard Cite

Section: The Role Of the Ias In Specific Anorectal Diseasementioning

confidence: 99%

The importance of the internal anal sphincter (IAS) in maintaining continence: anatomical, physiological and pharmacological considerations

et al. 2000

View full text Add to dashboard Cite

“…Chronische Krankheitsverl~iufe mit Narbenbildungen, sogenannten Vorpostenfalten, hypertrophierten Analpapillen und inkompletten inneren Fisteln sind eine h~iufige Folge [1,2,7,13]. Infolge dieser Schmerzen kommt es zu einer Verkrampfung des Musculus sphincter ani intemus, einer dadurch verursachten Abdrosselung der Blutgeffil3e und somit schlechten Spontanheilung.…”

unclassified

Schmerzanamnese von Analfissuren mit/ohne hypertrophierte Analpapillen und Vorpostenfalten sowie Ergebnisse nach Behandlung mit Glyceroltrinitratsalbe 0,3%

Brühl¹,

Schmauz

1999

Coloproctol

View full text Add to dashboard Cite

Zusammenfassung: Von 25 Patienten mit Analfissuren konnten acht Patienten durch zweimal tfigliche lokale Anwendung einer 0,3%igen Glyceroltrinitratsalbe geheilt werden. Diese acht Patienten wiesen eine Schmerzanamnese von nur wenigen Wochen Dauer auf. Zu Beginn der Behandlung wurden die Schmerzen (70%) als unertr 91 geschildert; hypertrophierte Analpapillen oder Vorpostenfalten fehlten. Bei zwei Patienten dieser Gruppe (n=10)erfolgte keine Abheilung, sie waren aber dennoch schmerzfrei. Die ª 15 Patienten hatten hypertrophierte Analpapillen und/oder Vorpostenfalten, wiesen eine Schmerzanamnese von mehr als einem Monat auf (73%), gaben Schmerzen an, die h6chstens als stark eingestuft werden konnten und zeigten nur leichte bzw. keinen Rª der Schmerzintensitfit sowie keine Epithelialisierung der Analfissur. Wenn hypertrophierte Analpapillen und/oder Vorpostenfalten vorliegen, sollte daher operativ und bei Analfissuren ohne hypertrophierte Analpapillen und/oder Vorpostenfalten konservativ mit relaxierenden Mal3nahmen behandelt werden.Abstract: Eight of 25 patients with anal fissures could be cured by means of a 0.3% glyceroltrinitrate ointment which was applied locally twice a day. This group of patients had a pain history of a few weeks only. At the onset of treatment the pain was regarded as unbearable (70%); hypertrophic anal papillas or sentinel piles were missing. No healing has achieved in 2 patients; they were, however, free of pain. The remaining 15 patients with hypertrophic anal papillas and sentinel piles hada pain history of more than 1 month (73%), the pain was reported at the most as strong and they showed only slight of no decrease of the pain intensity and no epithelialisation of the anal fissure. If hypertrophic anal papillas and/or sentinel piles are seen, the treatment should be surgically; in the case of anal fissures without hypertrophic anal papillas and/or sentinel piles treatment should be conservative with relaxing measures.

show abstract

Aetiology and treatment of anal fissure

Lund

Scholefield

1996

Journal of British Surgery

280

206

View full text Add to dashboard Cite

Anal fissure is a common problem that causes significant morbidity in a young and otherwise healthy population. Treatment has remained largely unchanged for over 150 years and the pathogenesis of this condition is not yet fully explained. Acute fissure should be treated conservatively with dietary modification. Chronic fissures do not respond to conservative treatment. The current recommended surgical treatment for chronic fissure is lateral internal sphincterotomy. However, there is a disturbance of continence in a sizeable proportion of those undergoing this procedure. As yet there is no proven non-surgical treatment for chronic fissure. Although local injection of botulinum toxin and the topical application of nitrates show early promise, further controlled trials are needed.

show abstract

Funktionelle Pathomechanismen der Analfissur

Cited by 4 publications

References 12 publications

The importance of the internal anal sphincter (IAS) in maintaining continence: anatomical, physiological and pharmacological considerations

The importance of the internal anal sphincter (IAS) in maintaining continence: anatomical, physiological and pharmacological considerations

Schmerzanamnese von Analfissuren mit/ohne hypertrophierte Analpapillen und Vorpostenfalten sowie Ergebnisse nach Behandlung mit Glyceroltrinitratsalbe 0,3%

Aetiology and treatment of anal fissure

Contact Info

Product

Resources

About