RESUMO
La fisura anal es una patología frecuente y probablemente la causante de la mayor parte de las proctalgias agudas severas. Esta revisión tiene por objetivo, evaluar los procedimientos actualmente utilizados para el tratamiento de esta enfermedad. En principio se describen algunos aspectos ligados a la etiopatogenia y a la evolución natural con la intención de comprender la utilización de las distintas modalidades terapéuticas. Posteriormente se analizan las características de cada método en particular, como así también sus beneficios, efectos adversos y resultados. Al final del trabajo, se expone el algoritmo de tratamiento seguido por los autores.
The anal fissure is a frequent pathology and probably the cause of most of the severe acute proctalgias. This revision has by objective, to evaluate the procedures at the moment used for the treatment of this disease. In principle some aspects related to etiopatogenia are described and to the natural evolution, with the intention to understand the use of different therapeutic modalities. Later the characteristics of each method in individual are analyzed, like thus also their benefits, adverse effects and results. At the end of the work, the algorithm of treatment followed by the authors is exposed.
Assuntos
Humanos , Fístula Retal/etiologia , Fissura Anal/cirurgia , Fissura Anal/classificação , Fissura Anal/complicações , Fissura Anal/dietoterapia , Fissura Anal/etiologia , Fissura Anal/tratamento farmacológico , Fissura Anal/terapia , Vasodilatadores/uso terapêutico , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/uso terapêutico , Cirurgia Colorretal/métodos , Dilatação/métodos , Fezes , História Natural das Doenças , Resultado do Tratamento , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas/uso terapêuticoAssuntos
Humanos , Fissura Anal/fisiopatologia , Fissura Anal/diagnóstico , Fissura Anal/tratamento farmacológico , Fissura Anal/dietoterapia , Recidiva , Doença Crônica , Sinais e Sintomas , Diagnóstico Diferencial , Sífilis/diagnóstico , Agranulocitose/complicações , /administração & dosagem , Diazepam/administração & dosagemAssuntos
Humanos , Doença Crônica , Fissura Anal/diagnóstico , Fissura Anal/dietoterapia , Fissura Anal/tratamento farmacológico , Fissura Anal/fisiopatologia , Recidiva , Agranulocitose/complicações , Anti-Inflamatórios não Esteroides/administração & dosagem , Diagnóstico Diferencial , Diazepam/administração & dosagem , Sífilis/diagnóstico , SintomatologiaRESUMO
The effect of unprocessed bran in a dose of 5 g three times daily and a dose of 2.5 g three times daily for one year on the recurrence rate of anal fissures was studied in a double-blind, placebo-controlled trial in 90 patients with recently healed acute posterior anal fissures. Fifteen patients (16.6%) were withdrawn before the code was broken due to failure to follow the trial protocol for various reasons. Significantly fewer recurrences occurred in patients receiving bran 5 g three times daily (recurrence rate 16%, 95% confidence limits, 4.54 to 36.08) when compared with patients receiving bran 2.5 g three times daily (60%; 38.67 to 78.87) (P less than 0.01) and with patients receiving placebo three times daily (68%; 46.50 to 85.05) (P less than 0.01). No significant difference in recurrences was found between patients on bran 2.5 g and those on placebo.
Assuntos
Fibras na Dieta/uso terapêutico , Fissura Anal/dietoterapia , Adolescente , Adulto , Canal Anal/fisiopatologia , Ensaios Clínicos como Assunto , Defecação , Método Duplo-Cego , Feminino , Fissura Anal/fisiopatologia , Flatulência , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , RecidivaRESUMO
18 patients with inflammatory bowel disease, among them ten with ulcerative colitis and 5 with Crohn's disease, were treated with the combined enteral-parenteral synthetic hypercaloric nutrition. By use of Vivasorb the clinical results were rather good. However, it was impossible to normalize the serumalbumin until the application of the formula diet BSD, enriched in amino acids. These experiences with BSD reveal much better results. All patients recovered nearly completely from their complaints and the clinical parameters went back to normal. Furthermore, it is easier to improve the flavour. The typical mode therapy is demonstrated on one patient with ulcerative colitis and one with Crohn's disease.