ABSTRACT
This is the second of two articles about the kinds of anorectal problem with which people can present at emergency departments. The first article concerns common symptoms and anorectal examination, while this one discusses the diagnosis and treatment of three common anorectal problems that can be managed by nurse practitioners: haemorrhoids, anal fissure and pruritus ani. Unexpected diagnoses might be found on examination and nurse practitioners should refer these patients to appropriate specialists.
Subject(s)
Fissure in Ano , Hemorrhoids , Pruritus Ani , Adult , Aged , Female , Fissure in Ano/diagnosis , Fissure in Ano/nursing , Fissure in Ano/therapy , Hemorrhoids/diagnosis , Hemorrhoids/nursing , Hemorrhoids/therapy , Humans , Male , Middle Aged , Nurse Practitioners , Pruritus Ani/diagnosis , Pruritus Ani/nursing , Pruritus Ani/therapyABSTRACT
Pruritus ani is a hidden but frequently occurring clinical condition, with a large impact on patients' quality of life. Currently, therapeutic options are scarce, offering mainly limited success. The authors performed a prospective, open-label, two-centre pilot study to analyse the efficacy and safety of a liquid-film forming acrylate cream for the treatment of pruritus ani and peri-anal skin irritation. A total of 28 patients were included and applied the cream to the cleansed anal and peri-anal skin once daily for a study period of 3-4 weeks. The primary outcome measure was the reduction of pruritis ani, comparing day 0 to day 28 results. For this purpose, a visual analog scale (VAS) was used. Secondary parameters included the physician global assessment score (PGA) of peri-anal skin condition, assessment of patients' quality of life using a specifically designed quality of life scoring tool, and patient satisfaction with the treatment regimen. The application of the acrylate skin protection cream resulted in a fast and substantial improvement of all study parameters, with a high score for patient satisfaction. The cream was well tolerated without any adverse events noted during the study period. The authors' pilot study has generated initial evidence that the acrylate skin protection cream may be effective for the treatment of pruritus ani. However, further randomized controlled studies are needed to confirm the authors' findings.
