An anal fissure is a disruption of the skin at the distal anal canal.
Most fissures are seen by separating the buttocks with opposing traction of the thumbs.
Majority of fissures are located in the posterior midline of the anus.
Acute fissures are simple splits or cracks in the anoderm while chronic fissures may show secondary changes eg sentinel tag, hypertrophied anal papilla, rolled edges, fibrosis of the edges or deep ulceration with exposure of the underlying internal anal sphincter muscle within the fissure's base.
Recently, randomized controlled trials and guidelines have brought to light the benefits of extending the duration of H. pylori treatment. Below are summaries of guidelines and trials examining the regimens used to manage the infection.
RB Health is committed to support healthcare quality improvement through CME activities that help physicians stay updated with the latest developments in medicine. At the RB symposium held in Kuala Lumpur, two distinguished speakers gave their insights into the management of acid reflux and sore throat – two of the most common reasons for patients to visit their doctors.