The epidemiology and treatment of anal fissures in a population-based cohort

BMC Gastroenterology

Research Article

Ann Von Worley¹  Douglas W Mapel¹  Michael Schum¹ 

[1] Lovelace Clinic Foundation, 2309 Renard Place SE, Albuquerque, 87106, New Mexico, NM, USA;

关键词: Anal fissure;    Epidemiology;    Risk factors;    Comorbidity;    Treatment;   

DOI  :  10.1186/1471-230X-14-129

 received in 2014-02-23, accepted in 2014-07-07,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAnal fissure (AF) is regarded as a common problem, but there are no published epidemiologic data, nor information on current treatment. The purpose of this study was to examine the incidence, associated comorbidities, and treatment of AF in a population-based cohort.MethodsWe conducted a retrospective analysis of all persons who were enrolled in one large regional managed care system and treated for AF during calendar years 2005–2011. All persons aged 6 years or older who had a clinic, hospitalization, or surgical procedure associated with AF were identified from utilization data. To identify comorbidities associated with AF, each case was matched by age and gender to 3 controls.ResultsThere were 1,243 AF cases, including 721 (58%) females and 522 (42%) males; 150 (12%) of the cases occurred in children aged 6–17 years. The overall annual incidence was 0.11% (1.1 cases per 1000 person-years), but ranged widely by age [0.05% in patients 6–17 years to 0.18% in patients 25–34 years]. The incidence also varied by sex, and was significantly higher among females 12–24 years, and among males 55–64 years (P < 0.001). Comorbidities associated with AF included chronic constipation (prevalence 14.2% vs 3.6%), hypothyroidism (14.7% vs 10.4%), obesity (13.0% vs 7.7%), and solid tumors without metastasis (5.2% vs 3.7%) (P < 0.001 for all comparisons). A total of 448 were dispensed a topical prescription medication, 31 had botulinum toxin injection, and only 13 had lateral internal sphincterotomy.ConclusionsAF is a common clinical problem, and the incidence varies substantially by age and sex. Constipation, obesity, and hypothyroidism are associated comorbidities. Most patients are prescribed topical treatments, although it appears that many prescriptions are never filled. Surgical interventions for AF including botulinum toxin and lateral internal sphincterotomy are uncommon.

【 授权许可】

CC BY   
© Mapel et al.; licensee BioMed Central Ltd. 2014