Diagnostic, pharmacological, surgical and behavioural developments in benign anorectal disease.

Abstract

The investigation of benign anorectal disease has been transformed by new techniques of imaging such as anal endosonography and magnetic resonance imaging. This has led to more specific surgical treatments when structural damage is identified. It has also led to the identification of newly recognised pathologies, such as primary internal sphincter degeneration which causes passive faecal incontinence. A variety of new treatment modalities is also emerging. Pharmacological therapies are assuming great importance in relation to anal disease, with topical glyceryl trinitrate now the first treatment of choice for chronic anal fissure. For patients with intractable constipation behavioural techni..