• CELLMED
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• v.13 no.13
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• pp.48.1-48.6
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• 2023

Objective: Case study of hemorrhoid improvement by ortho-cellular nutrition therapy. Methods: A Korean woman in her 40s had been experiencing hemorrhoid symptoms for two years, and recently, severe anal pain rendered her unable to carry out daily activities. Results: After implementing nutrition therapy, the patient's anal pain and edema were completely resolved. Conclusion: Applying nutrition therapy to patients with hemorrhoids can assist in symptom relief.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.217-220
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• 1999

Background: Transcutaneous Electrical Nerve Stimulation (TENS) has been widely used for pain relief after surgery instead of opioid analgesics therapy. This study was designed to study the effectiveness of TENS on perianal pain after anal surgery. Methods: Forty-eight patients who underwent anal surgery were evaluated in this suudy. Caudal anesthesia with 1.5% lidocaine 30 ml mixture 1：200,000 epinephrine was performed. TENS was done at 100 Hz for 25 min. duration, postoperatively at 4 hrs and 24 hrs. Pain was also measured at the 4 hrs and 24 hrs postoperatively by visual analogue scale (VAS). VAS value were compared before and after TENS application. Results: Values of VAS after TENS were significantly lower compared to those before TENS. Conclusions: From these results, we concluded, TENS may be effective for postoperative perianal pain relief after anal surgery.

• The Korean journal of internal medicine
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• v.39 no.3
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• pp.430-438
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• 2024

Background/Aims: A poor prognostic factor for Crohn's disease (CD) includes perianal fistulizing disease, including perianal fistula and/or perianal abscess. Currently, a tool to assess perianal symptoms in patients with CD remains nonexistent. This study aimed to develop a perianal fistulizing disease self-screening questionnaire for patients with CD. Methods: This prospective pilot study was conducted at three tertiary referral centers between January 2019 and May 2020. We formulated questions on perianal symptoms, including tenesmus, anal discharge, bleeding, pain, and heat. A 4-point Likert scale was used to rate each question. Patients with CD completed a questionnaire and underwent pelvic magnetic resonance imaging (MRI). Results: Overall, 93 patients were enrolled, with 51 (54.8%) diagnosed with perianal fistulizing disease, as determined by pelvic MRI. The Spearman correlation findings demonstrated that anal pain (p = 0.450, p < 0.001) and anal discharge (p = 0.556, p < 0.001) were the symptoms that most significantly correlated with perianal disease. For anal pain and discharge, the area under the receiver operating characteristic curve of the scores was significantly higher than that of the combined score for all five symptoms (0.855 vs. 0.794, DeLong's test p = 0.04). For the two symptoms combined, the sensitivity, specificity, and positive predictive and negative predictive values were 88.2, 73.8, 80.4, and 83.8%, respectively, with 81.7% accuracy for detecting perianal fistulizing disease. Conclusions: This study indicates that simple questions regarding anal pain and discharge can help accurately identify the presence of perianal fistulizing disease in patients with CD.

• The Korean Journal of Pain
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• v.32 no.1
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• pp.55-56
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• 2019

• Journal of Korean Neurosurgical Society
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• v.42 no.1
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• pp.46-48
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• 2007

Distant metastasis of squamous cell carcinoma from the anal canal is an uncommon event. However, hematogenous spread to the vertebrae may occur in the course of this disease. The route of metastasis from the anal canal seems to be Batson's vertebral venous system. A 52-year-old female patient presented with lower back and right leg pain of one-week history. She has undergone radiotherapy and chemotherapy for squamous cell carcinoma of the anal canal and then was followed by surgical resection. Three months later, magnetic resonance images of the lumbar spine disclosed a well-enhanced mass of L5 vertebral body compressing the thecal sac. Surgical decompression and biopsy were performed. Histopathological study confirmed carcinoma of the squamous cell origin. We report a ra re case of vertebral metastasis from squamous cell carcinoma of the anal canal with a pertinent review of literature.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.29 no.2
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• pp.180-186
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• 2016

Anal and perianal condyloma acuminatum(CA), which is a large cauliflower-like tumor, is a manifestation of human papillomavirus (HPV) infection. HPV may be acquired via sexual transmission, vertical transmission or nonsexual contact. It is an uncommon condition in children but the incidence in children has been increasing recently. There are many therapies for CA including chemical or physical destruction, immunological therapy, or a surgical excision. All these procedures have some degree of limitations such as limited clearance rate, high recurrence rate, pain, bleeding, release of potentially infectious aerosols and scar. It may be traumatic mentally to the children as well as physically. Korean Medicine included herbal treatment and herbal ointment for CA is no pain, and it doesn't need an anesthesia. We present a case of anal and perianal CA in a 2 years old boy that was treated successfully with Korean Medicine, with no recurrence during the follow up 3 months.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.263-266
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• 2005

The ganglion impar is a solitary retroperitoneal structure at the caudal end of the paravertebral sympathetic chain. Block of this ganglion has been advocated as a means of managing intractable perineal pain. In 1990, Plancarte et al performed a neurolytic block of the ganglion impar using 4-6 ml of 10% phenol through the intergluteal skin over the anococcygeal ligament. However, technical difficulties are encountered with the placement of the needle while performing this technique, with complications from the injection of phenol also being a possibility. In 1995, a modified approach for blocking the ganglion impar through the sacrococcygeal ligament was introduced by Wemm and Saberski. We used a radiofrequency (RF) lesion generator to create a controlled and localized lesion with a lower incidence of neural damages compared to chemical neurolysis. RF thermocoagulation of the ganglion impar through the sacrococcygeal ligament was performed on a 70-year-old male patient with constant anal pain using a curved TEW electrode. The patient has been relieved of his pain, without serious complication. Therefore, this technique may be an easier and safer approach, which is associated with fewer chances of complications.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.59-63
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• 1999

Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{\pm}1.54$, $19.7{\pm}2.22$ and $20.3{\pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{\pm}2.31$, $21.2{\pm}2.51$ and $23.3{\pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1289-1299
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• 2020

Background: Hemorrhoid surgery is a frequently performed surgery in Korea, second only to cataract surgery. However, it has serious complications, including bleeding, infection, anal stenosis, and urinary retention, so active conservative therapies are in need at an early stage. Case summary: Thirteen patients with anal disease complained of main symptoms of pain, bleeding, and prolapse, with additional complaints of itching and mucus discharge. An herbal medicine mixture of Eulja-tang and Hwangryeonhaedok-tang was administered twice daily, and dry cupping therapy, acupuncture, and hot pack placements were administered on pelvic and sacral regions once weekly for four weeks. The symptoms were evaluated before and each week after the treatments. The treatments had statistically significant therapeutic effects. Conclusion: Korean medicine treatment-effectively alleviating the symptoms of anal disease, such as pain, bleeding, and prolapse-may represent an alternative therapy for conservative treatments in the early stages of anal disease.

• Journal of Acupuncture Research
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• v.20 no.1
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• pp.131-143
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• 2003

Objective : The purpose of this study is to arrange the literature about acupuncture therapy on the hemorrhoids and hemorrhoid complicated by anal fistula. Methods : We arrange Huang Di Nei Jing and fifteen kinds of literature about the hemorrhoids and hemorrhoid complicated by anal fistula. Results : 1. The cause of hemorrhoids are overfatigue, overeating, imbalance of stool(const-ipation or diarrhea), uncontrol sexual excess or abstinence, pathgenic factors of wetness, heat, wind, dry, fire, chronical hemorrhoids that has not been treated, and general weakness. 2. Symptom of hemorrhoids is that skin is projected form the nine holes or varicose extension to become hemorrhoid. Hemorrhoids is small nodosity that projected on the anal inter or outer region, and hemorrhoid complicated by anal fistula is pus which comes out form one or some fistula on the anal around inter and outer region. 3. Therapy method of hemorrhoid and hemorrhoid complicated by anal fistula are elimination pathological heat from blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat form the blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat from the blood and eliminate dampness, tonify the spleen and replenish Ki, dispel wind and alleviate pain and so forth. Therapy method of hemorrhoid is to give the first consideration to relieve blood: eliminating pathological heat form blood complicated by anal fistula is to tonify the blood first, than after that eliminating pathological heat form blood. About external method are method of fumigation, method of ointment, method of close with medicine, necrotizing method and also operation(injection, bind etc.)was used for treatment. 4. The prescription are Gurgak-hwan, Wypi-hwan, Gunggyi-tang, Jingyochangchul-tang, Jingyobangpung-tang, Mokhyangbinrang-hwan, Ochi-san, Gamihyanso-san, Jojang-hwan, Sinyung-hwan used frequently. 5. food taboo on patient's diet of the hemorrhoid and hemorrhoid complicated by anal fistula are raw grain, cold or dampness food, alcohol, hot food, Singiberis rhizoma recens, Cinnamomi ramulus. 6. Acupuncture therapy on the hemorrhoid and hemorrhoid complicated by anal fistula are, in the first stage eliminating pathological heat form blood and eliminate dampness, and in the long term eliminate dampness, promote and remove meridian energy, remove that form the intestines, dispel channels and collaterals. 7. Acupuncture points at B2, CV1, B58, B36, B56, Sp5, S30, B25, B54, GV1, GV20, L6, B40 used frequently for the acupuncture therapy, and acupuncture point at GV4, GV1, B30, hemorrhoidal point used form moxibustion. Reduction blood at B40 and blue capillary of Sp9 and acupuncture Chungbaek, Ki-gack, Ki-jung, Ki-mun(Dongsh Kihyel) makes the treatment very effective.