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

Hemorrhoids are a common source of anorectal symptoms, which are determined by their size. A helpful measure in small hemorrhoids is a high-fiber diet; in moderate lesions, ligature therapy is effective. Surgery should be reserved for large hemorrhoids. Anal fissures, probably caused by trauma to the anal canal during defecation, may persist because of a cycle of hard stools, pain, and reflex spasm. A high-fiber diet and sitz baths relieve acute fissures. Lateral partial internal sphincterotomy is usually effective when they become chronic. Perianal abscess is often caused by acute infection of the anal glands; fistula is the result of chronic infection. Swelling and induration may be present. Pain is throbbing and continuous, and perianal examination may require use of an anesthetic. Incision and drainage with follow-up to ensure resolution of infection is required. Pruritus ani may result from several contributing conditions or may be idiopathic. Restoration of dry, intact perianal skin is the treatment goal. Patients should be taught gentle hygiene and drying methods and advised to avoid caffeine or other dietary items that seem to exacerbate symptoms. Condylomata acuminata cause bleeding and pain if allowed to progress. Biopsy should be considered in patients at risk of dysplasia. Repeated application of caustic topical agents may help small lesions. Large, extensive, and persistent lesions require surgical ablation.
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PMID:Anorectal disorders. Five common causes of pain, itching, and bleeding. 747 60

On the initiative of the Dutch Surgical Society a consensus meeting was held on December 3rd, 1993 in Utrecht, the Netherlands by the National Organisation for Quality Assurance in Hospitals (CBO), on the diagnosis and treatment of haemorrhoids. The following statements were formulated. Haemorrhoids are vascular cushions, covered by mucosa, originating from the plexus rectalis superior, and are part of the normal anatomy of man. Complaints from haemorrhoids occur if they prolapse. The usual 4-grade classification of haemorrhoids has no direct impact on their treatment. Portal hypertension is not a cause of haemorrhoids. Blood loss, a sensation of prolapse, pruritus and soiling are non-specific symptoms of haemorrhoids. Anaemia may only be attributed to haemorrhoids after other pathology has been excluded. Acute massive anorectal blood loss is frequently caused by traumatic damage to the rectum. Anticoagulant therapy is a risk factor. The presence of unexplained perianal skin lesions neccessitates further proctologic investigation. Haemorrhoids are not palpable on rectal digital examination. In patients under 50 with anorectal blood loss and a history of haemorrhoids, a proctoscopic examination is sufficient. Anorectal blood loss in patients over 50 requires exclusion of higher pathology. The regulation of defaecation and eating habits can have a preventive effect on the development of haemorrhoids. Conservative measures form the basis of treatment for haemorrhoidal complaints. Local antihaemorrhoidal treatment can only be expected to give short-term relief and is not a causal therapy. Barron elastic band ligation and sclerosing, in addition to infrared coagulation are treatment modalities in the outpatient setting that are very effective, inexpensive and optimally patient-friendly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Consensus hemorrhoids (Dutch Society for Surgery)]. 783 Aug 34

Main symptoms associated with hemorrhoids are anal bleeding, pruritus as well as weeping and superficial wounds of the rima ani and, finally, hemorrhoidal prolapse. The reason for the symptoms described is a relative anal incontinence due to hemorrhoidal knots prolapsing into the anal channel. There is evidence of an increased sphincteric pressure following increase of intraluminal pressure in colon and rectum in patients whose volumes of stool are too little because of small amounts of dietary fiber or regular use of laxatives. The stop of venous blood flow leads to a constant swelling of the vascular bed in the anal channel, which herniates during defection with variable intensity. Almost half of the patients suffering from hemorrhoids of grade 1 or grade 2 are treated successfully and conservatively (regulation of bowel habits by intake of large quantities of dietary fiber, change of life style and training of sphincter ani). Although injection therapy is used mostly, ligation of the prolapsing knots is the most physiological form of treatment: in retaining the vascular bed, the patient is able to keep complete continence. The consequent use of the former mentioned modes of treatment gives a 95% success rate in patients suffering from hemorrhoids. Only 5% need surgical intervention.
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PMID:[Hemorrhoidal diseases]. 797 76

The diagnosis and management of hemorrhoids, fissures, and pruritus ani probably accounts for more than 81% of the complaints centered on this part of the human anatomy. This brief treatise offers a safe and practical approach to the management of these three diseases.
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PMID:Hemorrhoids, fissures, and pruritus ani. 798 64

Chronic anal fissures have a varied and often confusing clinical presentation. To clarify this picture, we retrospectively studied 172 patients to determine associations between patient characteristics and manifestations of these lesions. We found that anterior fissures and sentinel piles were significantly more common in women; pruritus and rectal drainage occurred significantly more often in men; and patients with a longer duration of symptoms and those with pruritus and drainage were more likely to have a fistula. Younger patients were more likely to report rectal bleeding. Patients with chronic anal pruritus or an anal abscess should be carefully evaluated for an anal fistula, since anorectal problems may recur if a fistula remains untreated.
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PMID:Clinical presentation of chronic anal fissures. 821 67

Lignocaine is a rare contact allergen, in contrast to other local anaesthetics such as benzocaine, which commonly sensitize. The case of a patient sensitized to lignocaine through the use of a topical medication for the treatment of haemorrhoids is reported. Previous reports show that application of a lignocaine-containing preparation for pruritus ani is the most frequent cause of sensitization to lignocaine. The significance of sensitization to lignocaine is discussed in the light of its widespread use both in local anaesthesia and as an anti-arrhythmic.
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PMID:Contact sensitivity to lignocaine. 840 72

Postpartum haemorrhoids are a common problem, for which the recently marketed cooling device, Anurex (Roussel Uclaf Australia, Pennant Hills, NSW), was evaluated in 129 women randomly allocated to treatment and control groups. There was no difference in the rate of resolution of pain between the groups. The test group estimated a greater duration of pain relief, but this was not statistically significant. Anal bleeding and itching were not significantly reduced in the test group. There was no difference between discomfort scores related to application of the device in the groups, but a significant number in the test group encountered difficulty in insertion of the device. It is concluded that the introduction of the Anurex device as a standard method of treatment of postpartum haemorrhoids is not justified.
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PMID:Postpartum haemorrhoids--evaluation of a cooling device (Anurex) for relief of symptoms. 830 80

Haemorrhoids or piles are varicosities in the anal canal caused by local pressure. Sometimes they prolapse. Symptoms may include itching, discomfort, pain and bleeding. Haemorrhoids are common in pregnancy. Constipation aggravates piles, so a healthy diet with plenty of water and fibre is advisable. Some sufferers need an appropriate laxative as well. Cleanliness of the anal area is important. Proprietary moist toilet tissues are sold for this purpose and can be soothing and helpful. Relief of symptoms is by haemorrhoid creams, ointments and suppositories. Active ingredients typically include antiseptics, anti-inflammatories, anti-pruritics and local anaesthetics. Many are available from pharmacies without a prescription. If in doubt, always refer the patient to a doctor. For example, rectal bleeding may be due to some more serious condition, or pruritus to anal thrush. In the case of children the advice of a doctor should be sought.
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PMID:Remedies for common family ailments: 9. Haemorrhoids. 868 Feb 38

Due to the fact that the intensity of haemorrhoidal complaints may rapidly change, also numerous therapeutic approaches of minor effectiveness are considered a helpful remedy. However, the advantage of the Barron-ligature is not seriously doubted. By placing it correctly at the insensitive distal rectum, haemorrhoidal operations are only necessary in very advanced stages. Can the Barron ligature be optimized even more? Three patient groups consisting of 120 patients with 2nd degree haemorrhoids who were simultaneously treated by anal dilation using an appropriate lubricant for the anal dilator, were compared with each other in a randomized, open, placebo-controlled study conducted in two centres. In these groups treatment consisted of: rubber-band ligature alone rubber-band ligature and anal dilator and Kamillosan ointment rubber-band ligature and anal dilator and vaseline The observation period comprised six weeks. Every two weeks a check was made. Assessment criteria were: light-red haemorrhage, itching, oozing, sensation of incomplete evacuation, nodal prolapse and slight staining after defecation The pressure ratios of the closing apparatus were investigated at the beginning and end of the study. The group who had been treated with rubber-band ligature, anal dilator and Kamillosan ointment showed the best results. By simultaneously applying the rubber-band ligature, anal dilator and Kamillosan ointment as a lubricant, significantly better results could be obtained. The findings are based on a former retrospective study carried out in 500 patients with 2nd degree haemorrhoids. In this study by applying the anal dilator and Kamillosan ointment, the number of treatments could significantly be reduced from 5.95 to 4.2 and the number of necessary ligatures from 3.8 to 2.76 which, also from the economic point of view, was favourable.
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PMID:[Optimization of the Barron ligature treatment of 2nd and 3rd-degree hemorrhoids using a therapeutic troika]. 898 70

Anorectal diseases such as hemorrhoids, anal fissures, and anorectal abscesses are common in older patients. These conditions-along with and incontinence, rectal prolapse, and pruritus ani-cause considerable suffering and morbidity. The key to diagnosis remains the patient history, with confirmation by visual inspection and anoscopy. Expensive workups are usually not required. Most anorectal diseases can be easily treated in the outpatient setting with dietary changes and/or relatively minor procedures. Patients with more severe disease may require referral for surgery. Although uncommon, carcinomas do occur in the anorectal area, and lesions that cannot be identified by inspection should be biopsied.
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PMID:Anorectal disease: how to relieve pain and improve other symptoms. 911 40


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