Mistakes in managing perianal disease and how to avoid them

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Mistakes in managing perianal disease and how to avoid them

John T. Jenkins, Philip J. Tozer

Summary

AI Generated

This material discusses common and important mistakes in the management of perianal disease, a condition with varied presentations that significantly impairs quality of life.

Perianal disease takes many forms, is very common, and can significantly impair quality of life through symptoms including pain, bleeding, discharge, and pruritus.
These symptoms are common to several conditions that are sometimes difficult to disentangle from one another.
It is crucial to identify serious causes of perianal symptoms while also reducing the burden of less dangerous but debilitating conditions that can interfere with work, social, or intimate life.
The material presents management mistakes based on evidence where available and clinical experience where evidence is not available.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9

Riss S, et al. The prevalence of hemorrhoids in adults. Int J Colorectal Dis. 2012; 27: 215–220. [Link]

Nelson RL, et al. Non surgical therapy for anal fissure. Cochrane Database Syst Rev 2012: CD003431. [Link]

Alonso-Coello P, et al. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev 2005: CD004649. [Link]

Nasseri YY and Osborne MC. Pruritus ani: diagnosis and treatment. Gastroenterol Clin North Am 2013; 42: 801–813. [Link]

Hellers G, et al. Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease. Gut 1980; 21: 525–527. [Link]

Sahnan K, et al. P661 Abscess and fistula in Crohn's disease. 11th Congress of ECCO, Amsterdam 2016.

Tozer P. Anal fistula evaluation and management. In: Clark S (ed.) Colorectal Surgery. Companion to specialist surgical practice. 6th ed: Elsevier, 2016.

Tozer P, et al. Fistulotomy in the tertiary setting can achieve high rates of fistula cure with an acceptable risk of deterioration in continence. J Gastrointest Surg 2013; 17: 1960–1965. [Link]

Penninckx F, Lestar B and Kerremans R. The internal anal sphincter: mechanisms of control and its role in maintaining anal continence. Baillieres Clin Gastroenterol 1992; 6: 193–214. [Link]

10.

Thekkinkattil DK, et al. Measurement of anal cushions in idiopathic faecal incontinence. Br J Surg 2009; 96: 680–684. [Link]

11.

Owen BN, et al. Prevalence and frequency of heterosexual anal intercourse among young people: a systematic review and meta-analysis. AIDS Behav 2015; 19: 1338–1360. [Link]

Abstract

Perianal disease takes many forms, is very common and can impair quality of life significantly. The symptoms of perianal disease, including pain, bleeding, discharge and pruritus, are common to several conditions that are sometimes difficult to disentangle. It is crucial to identify the serious causes of perianal symptoms, but also to reduce the burden of the less dangerous conditions that nevertheless can be debilitating and interfere with an individual’s work, social or intimate life. Below we discuss some of the frequent and important mistakes made in the management of perianal disease based, where possible, on evidence, and where not, on clinical experience.

Topics

IBD Surgery

Citation

Tozer P and Jenkins JT. Mistakes in managing perianal disease and how to avoid them. UEG Education 2016: 16; 43–45.

Published

2016

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