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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review of the new concepts of the anatomy of the anal sphincter mechanism and the physiology of defecation is presented. The external sphincter is a triple-loop system; each loop can function as a separate sphincter through voluntary inhibition action and mechanical compression. Stress defecation resulting from internal sphincter damage is described. A new technique for repair of rectal incontinence is presented, which depends on inducing continence not only by mechanical compression, but also by voluntary inhibition. The mechanism of defecation and rectal continence is described and four types of incontinence presented. Also, the mechanism of both the levator dysfunction syndrome and prolapse is demonstrated and a technique of repair is presented. The study defines two types of rectal anomalies; suprahiatal and infrahiatal. The role of the embryonic anorectal sinus, anorectal band, and epithelial debris in the genesis of perirectal suppuration, chronic anal fissure, pruritus ani, and hemorrhoids is described. The communicating veins, identified between the hemorrhoidal and vesical plexuses, offer an explanation for the vague pathologic aspects of recurrent bacteriuria, urethral discharge, cervicitis, and vaginitis, and provide a proper line for their treatment. They also serve to perform a new radiographic technique--anal cystography--and to administer drugs, including chemotherapeutics, in the treatment of pelvic malignancies.
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PMID:A concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. 331 51

Pain, bleeding, protrusion, soilage, itching, and burning are anorectal complaints associated with hemorrhoidal disease. Although hemorrhoidectomy remains the treatment of choice for grade 3 and 4 hemorrhoids, symptoms can be controlled short of hemorrhoidectomy, the alternative methods being effective in lesser degrees of involvement, such as grades 1, 2, and 3. Cryosurgery and dilation are fading alternatives; laser is becoming more widely used, but results have not been fully evaluated. Sclerotherapy, rubber band ligation, and infrared coagulation are also effective alternatives for patients who demand nonsurgical therapy.
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PMID:Alternatives in the treatment of hemorrhoidal disease. 336 13

Management of pruritus ani rests on a few basic principles. The first and foremost is to listen to the patient and accept how uncomfortable and even disabling this common disorder can be. Such causes as parasites, diarrhea, trauma, hemorrhoids, and fistulas must be accurately diagnosed and treated. Contributing factors, such as poor hygiene or, paradoxically, too vigorous cleansing, must be corrected. Certain foods, such as spices and citrus fruits, need to be eliminated from the diet. Use of all over-the-counter preparations, cleaning pads, and solutions except water must be stopped. Finally, a mild steroid cream should be prescribed on a temporary basis, and the patient should be reexamined in two to three weeks. In the vast majority of cases, the physician will have a very happy and appreciative patient.
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PMID:Pruritus ani. 367 Dec 17

From 1978 to 1983, 111 patients with symptomatic internal hemorrhoids were treated as outpatients by a modification of the Barron ligation technique. Each ligated hemorrhoid was injected with a sclerosant. Follow-up, available for 94 of the patients, ranged from 2 to 60 months (mean 18 months). Presenting symptoms were bleeding in 75 (80%) of the 94 patients, pain in 46 (49%), pruritus in 22 (23%) and prolapse in 24 (26%). Results were excellent in 51 (54%) patients, good in 20 (21%) and fair in 9 (10%). Fourteen (15%) patients had unsatisfactory results; only 4 of these required hemorrhoidectomy. The other 10 had residual symptoms but did not require further treatment. Nine patients had minor complications, which included pain lasting 24 to 72 hours in seven, bleeding in one and syncope in one. The addition of sclerotherapy to traditional band ligation for the management of internal hemorrhoids has the advantages of exciting a greater inflammatory reaction between the mucosa and submucosa and preventing premature slipping of the band. The authors conclude that this method of therapy is effective for symptomatic hemorrhoids and that surgical hemorrhoidectomy is seldom indicated.
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PMID:Long-term follow-up of concomitant band ligation and sclerotherapy for internal hemorrhoids. 406 92

Anorectal disorders include a diverse group of pathologic processes that are frequently encountered in general medical practice but are poorly understood. The optimal management of anal pain, itching, bleeding, and incontinence is based on sound anatomic and pathophysiologic principles. Advances have been made in understanding the pathogenesis and management of four anorectal disorders frequently encountered by internists: hemorrhoids, fissures, pruritus, and incontinence.
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PMID:Common anorectal disorders. 638 55

Two groups of 18 patients undergoing sclerosant injection or rubber band ligation for first or mild, second degree hemorrhoids have been followed-up at three years after the initial treatment. Following sclerosant injections, four of 18 patients initially presenting with bleeding per rectum did not have further episodes of bleeding within the three year follow-up period compared with 13 of 17 treated with rubber band ligation. The other symptoms of pain or discomfort, pruritus ani and soiling were not present with sufficient frequency to allow specific evaluation. Results of this study demonstrate that rubber band ligation produces better long term results than does sclerosant injection in treating bleeding, the principal symptom, of first and mild, second degree hemorrhoids.
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PMID:Three year follow-up study on the treatment of first and second degree hemorrhoids by sclerosant injection or rubber band ligation. 664 73

The early and long-term results of treating 125 patients with advanced haemorrhoids by cryotherapy have been studied. Hospitalization requirements were brief; 54 per cent of patients were hospitalized for less than 24 h. The only significant early postoperative problem was a profuse serous discharge (67 per cent of patients). Bleeding, pain, or pruritus were rarely encountered. Ninety-three per cent of patients returned to work within 3 weeks. The principal long-term disadvantage was residual peri-anal skin tags and these were excised 6 months postoperatively in 18 patients. Four patients had first or second degree haemorrhoids at 2 years but only one patient (0.8 per cent) had prolapsing piles which required operation. Factors which might have influenced the results have been discussed. It is concluded that cryotherapy is an effective low cost method of dealing with advanced haemorrhoids.
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PMID:Cryotherapy for advanced haemorrhoids: a prospective evaluation with 2-year follow-up. 670 80

Bowel habit, anal pain or discomfort, pruritus ani and faecal soiling have been assessed in 82 patients with uncomplicated, prolapsing haemorrhoids before and after successful treatment (improvement in rectal bleeding and haemorrhoidal prolapse) by haemorrhoidectomy or rubber band ligation. An age and sex-matched control group of patients without haemorrhoids was similarly assessed. The bowel habit of the haemorrhoid group was not different from that of the control population. Pain or discomfort, pruritus and faecal soiling were much commoner in the pretreatment haemorrhoid group, compared to controls. Treatments designed to abolish rectal bleeding and prolapse (the cardinal symptoms of haemorrhoids) also reduced the incidence of these three symptoms. Only anal pain or discomfort, however, was reduced to the incidence found in the control group. Haemorrhoidectomy and rubber band ligation appeared equally effective in controlling all three symptoms. It is concluded that anal pain or discomfort, pruritus ani and faecal soiling are common symptoms of uncomplicated haemorrhoids and that they are abolished in the majority of patients by successful treatment for rectal bleeding and haemorrhoidal prolapse.
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PMID:The importance of pain, pruritus and soiling as symptoms of haemorrhoids and their response to haemorrhoidectomy or rubber band ligation. 697 87

Fifty patients with first or mild second degree haemorrhoids were randomly allocated to sclerosant injection (26) or rubber band ligation (24). One year after treatment 24 injection and 22 rubber band ligation patients were assessed. All patients presented with rectal bleeding; injection relieved 14 and rubber band ligation relieved 17 of this symptom (N.S.). Three of seven patients with prolapsing haemorrhoids who had sclerosant injections and five of seven who had rubber band ligation were relieved of this prolapse. However, a further six patients in the injection group developed prolapse for the first time during the one year follow-up period (p less than 0.05). Rubber band ligation relieved anal pain in 10 out of 14 patients whereas injection relieved only one patient of this symptom (p less than 0.05). Neither treatment influenced pruritus ani or faecal soiling. Although rubber band ligation caused more treatment discomfort, it is an effective management for first and mild second degree haemorrhoids and it should be considered as the procedure of choice.
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PMID:Comparison of rubber band ligation and sclerosant injection for first and second degree haemorrhoids-- a prospective clinical trial. 704 18

Common anorectal disorders can produce one or more of the following symptoms: pain, protrusion, pruritus, bleeding or discharge. The cause may be cryptitis, anal fissure, hemorrhoids, anorectal abscess, fistula in ano, neoplasm, condylomata acuminata, pilonidal cyst or inflammatory bowel disease. Each disorder is suggested by its characteristic history. Adequate examination by proctosigmoidoscopy will usually confirm the presence of the suspected disease.
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PMID:Anorectal disorders. 742 60


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