By Eli D., M.D. Ehrenpreis

Even supposing rectal and perianal lawsuits are one of the commonest visible via fundamental care physicians, surgeons, and gastroenterologists, the big variety of problems linked to those lawsuits are, in most cases, poorly understood. also, quite a few more recent diagnostic resonance imaging, are actually being hired for the review of those problems. eventually, new pharmacotherapies, together with immunosuppressants and topical cures in addition to new surgical remedies, have emerged. those are defined in a transparent, effortless demeanour.

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Relative contraindications Patient inability to cooperate with the procedure or severe anal stricture. Preparation of patient The patient should receive two Fleet’s enemas 1–3 hours before the procedure. How the procedure is performed The patient is placed in a left lateral position. The ultrasonographic device is placed inside a hard plastic cover for evaluation of the anal canal, or inside a water-filled balloon for visualization of the rectum, and these are introduced into the anus. Ultrasound frequencies are transferred from the probe to a computer where they 45 Chapter 2 are reconstructed into a visual image.

3. Hypertrophied anal papilla (originating at the dentate line) (see Figures 2 and 3). Treatment Medical First line: (45%–87% healing rate). Stool softeners, fiber supplements such as psyllium (6–12 g/day) or bran (10–15 g/day), local anesthetic agents (such as lidocaine, benzocaine, or pramoxine), or warm sitz baths. Relaxation and avoidance of straining when going to the bathroom may be beneficial. Second line: (77%–92% healing rate). 2% topical nitroglycerin – this must be specially compounded by the pharmacist from standard 2% nitroglycerin mixed with petroleum jelly or another vehicle (such as glycerin).

Identification of sources of colonic bleeding (see Figures 6 and 7); evaluation of the distal rectum and anal canal for bleeding sources; diagnosis of inflammatory bowel disease; determination of endoscopic and histologic severity of inflammatory bowel disease; surveillance of those carrying the diagnosis of ulcerative colitis or Crohn’s disease; and diagnosis of microscopic colitis. Figure 3. A sessile polyp of the ascending colon (top left). Figure 4. A pedunculated polyp in the descending colon (above).

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Anal and Rectal Diseases Explained by Eli D., M.D. Ehrenpreis
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