The Experts below are selected from a list of 273 Experts worldwide ranked by ideXlab platform
Anthony M. Vernava - One of the best experts on this subject based on the ideXlab platform.
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Pruritus ani
Diseases of the Colon & Rectum, 1994Co-Authors: Gayle L. Daniel, Walter E. Longo, Anthony M. VernavaAbstract:PURPOSE: The aim of this study was to determine how frequently pruritus ani (PA) is a symptom secondary to benign or malignant colon and Anorectal pathology. METHODS: One hundred nine patients with PA as the only presenting symptom were prospectively evaluated over a two-year period. All patients underwent anoscopy, rigid proctoscopy, and colonoscopy and were treated for PA. Patient data were entered into a computer data base and analyzed. RESULTS: The mean age was 52.1 years; males outnumbered females 2∶1. The mean duration of symptoms was 6.1 weeks. Mean coffee intake was four cups per day. Forty-five percent of patients smoked and 45 percent drank alcohol daily. Thirty-five percent had an abnormal proctosigmoidoscopy or colonoscopy. Twenty-seven (25 percent) patients had primary pruritus and 82 (75 percent) patients had coexisting colon or Anorectal pathology. The PA-associated neoplasia included rectal cancer (11 percent), anal cancer (6 percent), adenomatous polyps (4 percent), and colon cancer (2 percent). Hemorrhoids (20 percent) and anal fissures (12 percent) were the most common pruritus-related Anorectal Diseases. Among the 23 percent of patients with PA and neoplasia, pruritic symptoms were present longer compared with those with PA and Anorectal Disease
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Pruritus ani
Diseases of the Colon & Rectum, 1994Co-Authors: Gayle L. Daniel, Walter E. Longo, Anthony M. VernavaAbstract:PURPOSE: The aim of this study was to determine how frequently pruritus ani (PA) is a symptom secondary to benign or malignant colon and Anorectal pathology. METHODS: One hundred nine patients with PA as the only presenting symptom were prospectively evaluated over a two-year period. All patients underwent anoscopy, rigid proctoscopy, and colonoscopy and were treated for PA. Patient data were entered into a computer data base and analyzed. RESULTS: The mean age was 52.1 years; males outnumbered females 2∶1. The mean duration of symptoms was 6.1 weeks. Mean coffee intake was four cups per day. Forty-five percent of patients smoked and 45 percent drank alcohol daily. Thirty-five percent had an abnormal proctosigmoidoscopy or colonoscopy. Twenty-seven (25 percent) patients had primary pruritus and 82 (75 percent) patients had coexisting colon or Anorectal pathology. The PA-associated neoplasia included rectal cancer (11 percent), anal cancer (6 percent), adenomatous polyps (4 percent), and colon cancer (2 percent). Hemorrhoids (20 percent) and anal fissures (12 percent) were the most common pruritus-related Anorectal Diseases. Among the 23 percent of patients with PA and neoplasia, pruritic symptoms were present longer compared with those with PA and Anorectal Disease
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Colonoscopy in patients with benign Anorectal Disease
Diseases of the colon and rectum, 1993Co-Authors: Walter E. Longo, Philip A. Dean, Katherine S. Virgo, Anthony M. VernavaAbstract:A prospective study was performed to determine the incidence of colorectal neoplasia and inflammatory bowel Disease in patients with benign Anorectal Disease. Over a three-year period, 102 consecutive patients who presented with hemorrhoids, fissure, fistula-in-ano, Anorectal abscess, and anal condylomata and who did not have gastrointestinal symptoms underwent colonoscopy. The mean age of all patients was 535 years; males outnumbered females 1.6∶1. No patient was found to have inflammatory bowel Disease. Ten of 102 (9.8 percent) were found to have a neoplastic lesion (nine adenomas and one adenocarcinoma). Patients found to have a neoplastic lesion tended to be older (61 yearsvs.52.7 years;P=0.06). Neoplasia was found in 4 of 21 (19 percent) with a family history of colorectal cancer and in 6 of 81 (7.4 percent) without a family history (P=0.24). Patients presenting with outlet-type bleeding were not found to have a higher detection of neoplasia. The specific type of Anorectal Disease present was not associated with an increased risk for colorectal neoplasia. Our study suggests that benign Anorectal Disease and colorectal neoplasia may coexist. Anorectal Disease is not predictive of neoplasia. The decision to perform colonoscopy should be based on age, gastrointestinal symptoms, and other risk factors.
Walter E. Longo - One of the best experts on this subject based on the ideXlab platform.
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Utility of magnetic resonance imaging in Anorectal Disease
World journal of gastroenterology, 2007Co-Authors: Loren Berman, Gary M. Israel, Shirley Mccarthy, Jeffrey C. Weinreb, Walter E. LongoAbstract:Imaging of both benign and malignant Anorectal Diseases has traditionally posed a challenge to clinicians, and as a result history and physical exam have been relied on heavily. CT scanning and endorectal ultrasound have become popular in assessment of anatomy and staging of tumors, but have limitations. Magnetic resonance imaging (MRI) has the capability to fill in the gaps left open by more conventional imaging modalities and continues to be promising as the definitive imaging technique in the pelvis, especially with advancement of emerging technologies in this field. A comprehensive review of this topic has been undertaken. Anorectal Disease is divided into three broad categories: cancer, fistula/abscess, and pelvic floor disorders. A review of the literature is performed to evaluate the use of MRI and other imaging modalities in these three areas. Preoperative imaging is useful in the evaluation of all three areas of Anorectal Disease. MRI is an effective tool in delineating anatomy and, when correlating with the specific clinical scenario, is an effective adjunct in clinical decision-making in order to optimize outcome. MRI continues to be a promising and novel approach to imaging various afflictions of the anorectum and the pelvic floor. Its role is more well-established in some areas than in others, and there are still significant limitations. As technology advances, MRI will shed more light on a complex anatomical area.
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Pruritus ani
Diseases of the Colon & Rectum, 1994Co-Authors: Gayle L. Daniel, Walter E. Longo, Anthony M. VernavaAbstract:PURPOSE: The aim of this study was to determine how frequently pruritus ani (PA) is a symptom secondary to benign or malignant colon and Anorectal pathology. METHODS: One hundred nine patients with PA as the only presenting symptom were prospectively evaluated over a two-year period. All patients underwent anoscopy, rigid proctoscopy, and colonoscopy and were treated for PA. Patient data were entered into a computer data base and analyzed. RESULTS: The mean age was 52.1 years; males outnumbered females 2∶1. The mean duration of symptoms was 6.1 weeks. Mean coffee intake was four cups per day. Forty-five percent of patients smoked and 45 percent drank alcohol daily. Thirty-five percent had an abnormal proctosigmoidoscopy or colonoscopy. Twenty-seven (25 percent) patients had primary pruritus and 82 (75 percent) patients had coexisting colon or Anorectal pathology. The PA-associated neoplasia included rectal cancer (11 percent), anal cancer (6 percent), adenomatous polyps (4 percent), and colon cancer (2 percent). Hemorrhoids (20 percent) and anal fissures (12 percent) were the most common pruritus-related Anorectal Diseases. Among the 23 percent of patients with PA and neoplasia, pruritic symptoms were present longer compared with those with PA and Anorectal Disease
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Pruritus ani
Diseases of the Colon & Rectum, 1994Co-Authors: Gayle L. Daniel, Walter E. Longo, Anthony M. VernavaAbstract:PURPOSE: The aim of this study was to determine how frequently pruritus ani (PA) is a symptom secondary to benign or malignant colon and Anorectal pathology. METHODS: One hundred nine patients with PA as the only presenting symptom were prospectively evaluated over a two-year period. All patients underwent anoscopy, rigid proctoscopy, and colonoscopy and were treated for PA. Patient data were entered into a computer data base and analyzed. RESULTS: The mean age was 52.1 years; males outnumbered females 2∶1. The mean duration of symptoms was 6.1 weeks. Mean coffee intake was four cups per day. Forty-five percent of patients smoked and 45 percent drank alcohol daily. Thirty-five percent had an abnormal proctosigmoidoscopy or colonoscopy. Twenty-seven (25 percent) patients had primary pruritus and 82 (75 percent) patients had coexisting colon or Anorectal pathology. The PA-associated neoplasia included rectal cancer (11 percent), anal cancer (6 percent), adenomatous polyps (4 percent), and colon cancer (2 percent). Hemorrhoids (20 percent) and anal fissures (12 percent) were the most common pruritus-related Anorectal Diseases. Among the 23 percent of patients with PA and neoplasia, pruritic symptoms were present longer compared with those with PA and Anorectal Disease
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Colonoscopy in patients with benign Anorectal Disease
Diseases of the colon and rectum, 1993Co-Authors: Walter E. Longo, Philip A. Dean, Katherine S. Virgo, Anthony M. VernavaAbstract:A prospective study was performed to determine the incidence of colorectal neoplasia and inflammatory bowel Disease in patients with benign Anorectal Disease. Over a three-year period, 102 consecutive patients who presented with hemorrhoids, fissure, fistula-in-ano, Anorectal abscess, and anal condylomata and who did not have gastrointestinal symptoms underwent colonoscopy. The mean age of all patients was 535 years; males outnumbered females 1.6∶1. No patient was found to have inflammatory bowel Disease. Ten of 102 (9.8 percent) were found to have a neoplastic lesion (nine adenomas and one adenocarcinoma). Patients found to have a neoplastic lesion tended to be older (61 yearsvs.52.7 years;P=0.06). Neoplasia was found in 4 of 21 (19 percent) with a family history of colorectal cancer and in 6 of 81 (7.4 percent) without a family history (P=0.24). Patients presenting with outlet-type bleeding were not found to have a higher detection of neoplasia. The specific type of Anorectal Disease present was not associated with an increased risk for colorectal neoplasia. Our study suggests that benign Anorectal Disease and colorectal neoplasia may coexist. Anorectal Disease is not predictive of neoplasia. The decision to perform colonoscopy should be based on age, gastrointestinal symptoms, and other risk factors.
Helen Corby - One of the best experts on this subject based on the ideXlab platform.
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Anal canal pressures are low in women with postpartum anal fissure
British Journal of Surgery, 2005Co-Authors: Helen Corby, V S Donnelly, Colm O'herlihy, P. R. O'connellAbstract:Background Anal sphincter hypertonia is commonly thought to underlie development of anal fissure, yet anal fissure is particularly common after childbirth, a time when anal canal pressure may be reduced. This paradox was investigated by a prospective study of the effect of parturition on the pelvic floor. Methods Anal manometry was performed 6 weeks before and after delivery in 209 primigravid women with no pre-existing history of Anorectal Disease. Postpartum studies only were performed on a further 104 primiparae. Anal fissure was diagnosed by history and direct examination. Results Some 29 women (9 per cent) developed postpartum anal fissure. Antepartum anal canal resting and squeeze pressures were similar in women who did and those who did not develop fissure. Resting and squeeze anal canal pressures decreased post partum in both groups. Postpartum constipation was more common in those with fissure (62 per cent) than in those without (29 per cent) ( X 2 = 10.6, 1 d.f., P
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anal canal pressures are low in women with postpartum anal fissure
British Journal of Surgery, 1997Co-Authors: Helen Corby, V S Donnelly, Colm Oherlihy, P R OconnellAbstract:Background Anal sphincter hypertonia is commonly thought to underlie development of anal fissure, yet anal fissure is particularly common after childbirth, a time when anal canal pressure may be reduced. This paradox was investigated by a prospective study of the effect of parturition on the pelvic floor. Methods Anal manometry was performed 6 weeks before and after delivery in 209 primigravid women with no pre-existing history of Anorectal Disease. Postpartum studies only were performed on a further 104 primiparae. Anal fissure was diagnosed by history and direct examination. Results Some 29 women (9 per cent) developed postpartum anal fissure. Antepartum anal canal resting and squeeze pressures were similar in women who did and those who did not develop fissure. Resting and squeeze anal canal pressures decreased post partum in both groups. Postpartum constipation was more common in those with fissure (62 per cent) than in those without (29 per cent) ( X 2 = 10.6, 1 d.f., P<0.01). The mode of delivery or use of epidural analgesia did not affect the incidence of fissure. Conclusion Postpartum anal fissure is associated with reduced anal canal pressures, and surgical interference with the anal sphincter mechanism should be avoided.
P. R. O'connell - One of the best experts on this subject based on the ideXlab platform.
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Anal canal pressures are low in women with postpartum anal fissure
British Journal of Surgery, 2005Co-Authors: Helen Corby, V S Donnelly, Colm O'herlihy, P. R. O'connellAbstract:Background Anal sphincter hypertonia is commonly thought to underlie development of anal fissure, yet anal fissure is particularly common after childbirth, a time when anal canal pressure may be reduced. This paradox was investigated by a prospective study of the effect of parturition on the pelvic floor. Methods Anal manometry was performed 6 weeks before and after delivery in 209 primigravid women with no pre-existing history of Anorectal Disease. Postpartum studies only were performed on a further 104 primiparae. Anal fissure was diagnosed by history and direct examination. Results Some 29 women (9 per cent) developed postpartum anal fissure. Antepartum anal canal resting and squeeze pressures were similar in women who did and those who did not develop fissure. Resting and squeeze anal canal pressures decreased post partum in both groups. Postpartum constipation was more common in those with fissure (62 per cent) than in those without (29 per cent) ( X 2 = 10.6, 1 d.f., P
P R Oconnell - One of the best experts on this subject based on the ideXlab platform.
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anal canal pressures are low in women with postpartum anal fissure
British Journal of Surgery, 1997Co-Authors: Helen Corby, V S Donnelly, Colm Oherlihy, P R OconnellAbstract:Background Anal sphincter hypertonia is commonly thought to underlie development of anal fissure, yet anal fissure is particularly common after childbirth, a time when anal canal pressure may be reduced. This paradox was investigated by a prospective study of the effect of parturition on the pelvic floor. Methods Anal manometry was performed 6 weeks before and after delivery in 209 primigravid women with no pre-existing history of Anorectal Disease. Postpartum studies only were performed on a further 104 primiparae. Anal fissure was diagnosed by history and direct examination. Results Some 29 women (9 per cent) developed postpartum anal fissure. Antepartum anal canal resting and squeeze pressures were similar in women who did and those who did not develop fissure. Resting and squeeze anal canal pressures decreased post partum in both groups. Postpartum constipation was more common in those with fissure (62 per cent) than in those without (29 per cent) ( X 2 = 10.6, 1 d.f., P<0.01). The mode of delivery or use of epidural analgesia did not affect the incidence of fissure. Conclusion Postpartum anal fissure is associated with reduced anal canal pressures, and surgical interference with the anal sphincter mechanism should be avoided.