Nifedipine for local use in conservative treatment of anal fissures: preliminary results of a multicenter study. 2000 43:1048-58.Īntropoli C, Perrotti P, Rubino M, Martino A, De Stefano G, Migliore G, et al. Internal sphincterotomy is superior to topical nitroglycerine in the treatment of chronic anal fissure: results of a randomized, controlled trial by the Canadian Colorectal Surgical Trials Group. Richard CS, Gregoire R, Plewes EA, Silverman R, Burul C, Reznick R, et al. Glyceryl trinitrate for chronic anal fissure-healing or headache? Results of a multicenter, randomized, placebo-controlled, double-blind trial. 1995 333:1156-7.Īltomare DF, Rinaldi M, Milito G, Arcana F, Spinelli F, Nardelli N, et al. Topical nitroglycerin therapy for anal fissures and ulcers. Patient selection and treatment modalities for chronic anal fissure. ‘Reversible chemical sphincterotomy’ by local application of glyceryl trinitrate. Loder PB, Kamm MA, Nicholls RJ, Phillips RK. A randomised, prospective, double-blind, placebo-controlled trial of glyceryl trinitrate ointment in treatment of anal fissure. The clinical effectiveness and cost-effectiveness of screening for anal squamous intraepithelial lesions in homosexual and bisexual HIV-positive men. Goldie SJ, Kuntz KM, Weinstein MC, Freedberg KA, Welton ML, Palefsky JM. The relationship of human papillomaviruses to anorectal neoplasia. Noffsinger A, Witte D, Fenoglio-Preiser CM. Epidemiologic evidence and human papillomavirus infection as a necessary cause of cervical cancer. Patientapplied podofilox for treatment of genital warts. 1998 42:789-94.īeutner KR, Conant MA, Friedman-Kien AE, Illeman M, Artman NN, Thisted RA, et al. Imiquimod, a patient-applied immune-response modifier for treatment of external genital warts. 1992 11:247-55.īeutner KR, Tyring SK, Trofatter KF, Douglas JM, Spruance S, Owens ML, et al. 1993 sexually transmitted diseases treatment guidelines. 1989 29:286-8.Ĭenters for Disease Control and Prevention. Androscopy: a technique for examining men for condyloma. Epidemiology of genital human papillomavirus infections. If familial polyposis is confirmed, consider colectomy otherwise, endoscopy every 1 to 2 yearsįamily history of hereditary nonpolyposis colon cancerĬolonoscopy and counseling to consider genetic testingĮvery 2 years until age 40, then every year If normal, colonoscopy in 3 years if still normal, colonoscopy every 5 yearsĬolorectal cancer or adenomatous polyp in first-degree relative before age 60Ĥ0 (or 10 years before the youngest case in the family, whichever is earlier)Ĭolorectal cancer or adenomatous polyps in two or more first degree relatives of any ageĬolorectal cancer in any other relatives (not included above)Īs per average risk recommendations above may consider beginning screening before age 50įamily history of familial adenomatous polyposisĮarly surveillance with endoscopy, counseling to consider genetic testing and referral to a specialty center Personal history of curative-intent resection of colorectal cancer Patients with one large (≥1 cm) adenomatous polyp or multiple adenomatous polyps of any sizeĬolonoscopy within 3 years after initial polyp removal if normal, colonoscopy every 5 years Patients with single, small (<1 cm) adenomatous polypsĬolonoscopy within 3 years after initial polyp removal if normal, as per average risk recommendations above Once cancer is ruled out, more than 90 percent of anorectal complaints can be managed in the primary care physician's office using simple techniques.Īll patients age 50 and over not in the categories belowįOBT every year and flexible sigmoidoscopy every 5 yearsĬolonoscopy every 5 to 10 years or DCBE every 5 to 10 years Colorectal cancer can be cured only if found early. Cancer can coexist with benign lesions, so complete assessment is necessary. It is a grave error to automatically assume that every patient who presents with common, mild or occasional symptoms has only a benign condition such as hemorrhoids. Further testing and examination, including sigmoidoscopy or colonoscopy are indicated in select patients. This examination must include abdominal examination, visual inspection of the anal and perineal areas, digital rectal palpation and anoscopic visualization, preferably using an Ive's slotted anoscope (see part I: Symptoms and Complaints). A thorough physical examination should be performed to detect and evaluate all anorectal lesions. Pathologic findings are often discovered during a routine examination or during assessment of symptoms. Patients frequently present to family physicians for evaluation of lesions in the anorectal area.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |