By rray, 11 December, 2014 BMI 25-29.9 with ↑ CVD risk (HTN, dyslipidemia, DM/prediabetes, ↑ waist circ) or other obesity-related comorbidity (eg, sleep apnea)
By rray, 11 December, 2014 BMI 25-29.9 w/o ↑ CVD risk (HTN, dyslipidemia, DM/prediabetes, ↑ waist circ) or other obesity-related comorbidity (eg, sleep apnea)
By rray, 11 December, 2014 Local botulinum toxin4 internal anal sphincter injections SR L If botulinum injection fails LIS is recommended
By rray, 11 December, 2014 Surgical lateral internal sphincterotomy3 SR H minimal incision preferred LIS is surgical tx of choice for refractory fissures more efficacious than topicals or injectable tx
By rray, 11 December, 2014 Chronic features: edema/fibrosis; internal anal sphincter fibers may be seen at base; may typically see skin tag (sentinel pile) distally, hypertrophied anal papilla proximally