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

Current ideas on the etiology and pathogenesis of functional disorders of the large intestine are discussed. Their classification, clinical picture, principles of diagnosis and differential diagnosis are outlined with emphasis of the most spread functional diseases of the large intestine: functional (common) obstipation, irritation of the large intestine pruritus ani, insufficiency of anal sphincters, proctalgia. Special attention is paid to treatment (diet, drugs, physiotherapy, spa).
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PMID:[The functional disorders of the large intestine (a lecture)]. 129 31

Over a five-year period (1982-86), 77 patients (59 males, 18 females; mean age 41.32 y) with fistula in ano treated at the University of Ife Teaching Hospitals Complex were reviewed. As many as 66.24 per cent of these patients presented rather late at the hospital after 2 yr from the onset of illness. Significant clinical presentation included rectal pain, perianal itching, lax-anal-sphincteric tone and purulent fistula discharge. Low and posterior fistula was seen in as many as 49 cases, while 29 patients presented with high fistula. Fistulograms were done in 69 patients. All the patients had surgery with no post-operative complications and recurrence.
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PMID:Fistula in ano in Nigerians. 281 23

From October 1985 through June 1986, 31 children in a single pediatric practice were treated for perianal signs and symptoms associated with growth of group A beta-hemolytic streptococci from perianal cultures. Signs and symptoms included perianal dermatitis (90%), perianal itching (78%), rectal pain (52%), and blood-streaked stools (35%). Ages ranged from 7 months to 8 years mean 4.25 +/- 1.8 years). There were 24 boys (77%) and seven girls (23%). The 31 cases occurred in 19 families. Intrafamily spread was only to siblings and occurred in 50% of the possible situations. Direct perianal antigen studies had a sensitivity of 89% for predicting positive cultures. Four different T types of group A streptococci were isolated from these cases, but the T type within each family outbreak was identical except in one case. When group A streptococci were found in the pharynx (64% of patients), the T type of the pharyngeal and perianal isolates were identical. Treatment was usually with oral penicillin. Relapses occurred in 39%. Signs of cellulitis were absent in all 31 cases and, therefore, we suggest that the nomenclature for this entity be changed from streptococcal perianal cellulitis to streptococcal perianal disease.
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PMID:Streptococcal perianal disease in children. 331 56

Perianal streptococcal dermatitis is a bright red, sharply demarcated rash that is caused by group A beta-hemolytic streptococci. Symptoms include perianal rash, itching and rectal pain; blood-streaked stools may also be seen in one third of patients. It primarily occurs in children between six months and 10 years of age and is often misdiagnosed and treated inappropriately. A rapid streptococcal test of suspicious areas can confirm the diagnosis. Routine skin culture is an alternative diagnostic aid. Treatment with amoxicillin or penicillin is effective. Follow-up is necessary, because recurrences are common.
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PMID:Perianal streptococcal dermatitis. 1067 May 5

Necessity of research of teenagers after violent actions of sexual character is connected basically with anogenital sexual contacts. Survey of victims by the medicolegal (forensics medicines) expert assumes knowledge of illnesses like anorectal complex, causing anorectal dysfunctions (perianal itch, proctalgia, a crack of anal tract, encopresis). All specified diseases concerned with anorectal rings can be idiopatic (without the established reason) and secondary (locks, violent actions of sexual character, medical manipulations, traumas). On suspicion of anal penetration in children, survey should be carried out after obligatory conversation with the psychologist and with special feeling of a step, taking into account age factors and diseases of mental sphere. Such survey demands a certain algorithm of inspection, whose basic stages consist of the following: (1) Survey of anal areas will be carried out after preliminary conversation and examinations of other sites of a body in knee-elbow position. Whenever possible, the expert should be on floor with surveyed. (2) Hands of the expert should be warm so as not to provoke a pressure of muscles in the anus. (3) The anal reflex is checked by an easy touch, without painful variant, to a superficial part anal apertures (external sphincter is tunicae reduced, back pass is involved). (4) Children, as a rule, do not keep sphincter, a strong-willed pressure and therefore, reduction of a reflex is accompanied by reduction of force as a result of reduction of sphincter and its tone.
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PMID:Consequences for the teenagers after anogenital sexual contacts. 1293 39

Perianal Paget's disease (PPD) is an extremely rare condition characterized as intraepithelial adenocarcinoma of unclear etiology. It can be either primary or secondary. The disease typically presents as an eczema-like, erythematous, and painful skin lesion that is associated with pruritus. It is usually misdiagnosed as a common anorectal problem. Surgical excision is the preferred treatment of PPD, with the specific technique being dependent upon disease invasiveness. The treatment may involve reconstructive surgery. A 61-year-old female with a history of rectal pain and intermittent pruritus for the past two years presented with large painful lesions in her perianal area including the anal verge, diagnosed as primary PPD. After excluding other malignancies elsewhere, a laparoscopic ileostomy followed by a wide local excision (WLE) of the PPD was performed by a colorectal team. Reconstruction of the defect with gluteal advancement flaps was performed by the plastic surgeon. The patient recovered uneventfully. Her surgical site showed healing without flap compromise, widely open anal opening, and full sphincter control at the three-month follow-up exam. The patient returned to normal function after ileostomy closure. WLE with bilateral V-Y gluteal flap advancement is a feasible treatment for primary PPD.
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PMID:Wide local excision of perianal Paget's disease with gluteal flap reconstruction: an interdisciplinary approach. 2907 44

Benign anorectal conditions produce anal pain, rectal bleeding, or discharge from the perianal region, which are highly prevalent symptoms in the general population. Hemorrhoidal disease, anal fissure, perianal abscess, proctalgia syndromes, and pruritus anii are the most common clinical disorders. Well-trained physicians, irrespective of their specialty, can treat most of these disorders and refer them to a specialist in proctology only when necessary. The aim of this review is to provide a practical guide to the management of benign anorectal disorders in terms of their initial management and the criteria for specialist referral.
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PMID:Management of Common Benign Anorectal Disease: What All Physicians Need to Know. 2949 72

Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be considered in the differential diagnosis. History and examination, including anoscopy, are usually sufficient for diagnosing these conditions, although additional testing is needed in some situations. The primary treatment for hemorrhoids is fiber supplementation. Patients who do not improve and those with large high-grade hemorrhoids should be referred for surgery. Acutely thrombosed external hemorrhoids should be excised. Perianal pruritus should be treated with hygienic measures, barrier emollients, and low-dose topical corticosteroids. Capsaicin cream and tacrolimus ointment are effective for recalcitrant cases. Treatment of acute anal fissures with pain and bleeding involves adequate fluid and fiber intake. Chronic anal fissures should be treated with topical nitrates or calcium channel blockers, with surgery for patients who do not respond to medical management. Patients with functional rectal pain should be treated with warm baths, fiber supplementation, and biofeedback. Patients with superficial perianal abscesses not involving the sphincter should undergo office-based drainage; patients with more extensive abscesses or possible fistulas should be referred for surgery. Condylomata can be managed with topical medicines, excision, or destruction. Patients with rectal prolapse should be referred for surgical evaluation. Biofeedback is a first-line treatment for fecal incontinence, but antidiarrheal agents are useful if diarrhea is involved, and fiber and laxatives may be used if impaction is present. Colostomy can help improve quality of life for patients with severe fecal incontinence.
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PMID:Benign Anorectal Conditions: Evaluation and Management. 3189 30