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The Finicial Post

Have you given up hope of ever getting rid of rectal irritation? Every year I see patients who have tries an array of over-the-counter preparations. They've consulted a variety of physicians to no avail. And some have undergone a hemorrhoidectomy without relief of symptoms.

However, for many of these patients, relief is as close an the refrigerator door. Anurex, a cold rectal probe, is one oh the best-kept secrets for treating this irritating problem. Rectal irritation maybe assiociated with poor hygiene and hemorrhoids. But there's another condition called anusitis that is often the culprit and I doubt one patient in a thousand has every heard of this diagnosis.

They're not alone. Dr. William Rudd, director of the Rudd Clinic for Colon and Rectal Surgery in Toronto, claims that for years doctor have failed to diagnose anusitis. Anusitis causes a slight amount of discharge around the anal area. This constant wetness macerates the skin and causes multiple tiny cracks that trigger itching. It starts a vicious cycle. The more patients scratch the more they itch.

A major complant is a buring sensatio, inside and outside the anus. There is no swelling, but blood is often found on toilet paper and occasionally considerable bleeding occurs,. Inserting a finger into the anus causes pain.

Rudd and his colleagues examined 100 consecutive patients referred to the clinic for rectal problems. Both the referring doctors and the patients belived their sympthoms were due to hemorrhoids. But only 31% actually had this problem; 34% suffered from anusitis. The rest had a variety of anal and rectal troubles.

It's logical to ask, "How could so many physicians fail to notice this inflamed area just inside the anus?" Russ says it's casy.

The anal canal, he explains, is the bowel's "no man's land." It's only three centimeters in length. Moreover, unlike the higher rectal area, the anal canal is always collapsed. And a collapsed bowel isn't as easy to see as a dilated one.

There's also an important techmocal problem that makes diagnosis difficult. During signoidoscopic examination, doctors insert a lighted instrument into the large bowel to search for polyps, inflammation or malignancy. During insertion and withdrawal of the signoidoscope, it passes trough the short, collapsed anal canal so quickly that annusitis goes undetected.

What causes anusitis? Rudd claims the main offenders are coffee, beer, colas, pizza and garlic. Anibicotics, diarrhea and tension can be factors; on rare occasions, smoking and food allergies. A change in diet is the long-term answer for treating anusitis. But immediate relief is as close as the refiegerator's freezier.

There's nothing new about the aplication of cold (cryotherapy) to relieve swelling ans sports injuries. And it's often used to treat premalignant conditions in gynecology. However, until recently, no one thought of using cryothepary to soothe the symptoms of anal imitation.

Anurex, which contains a cold retaining gel, is cooled in the freezer for a minimum of one hour. A watersouble lubricant is applied to the Anurex probe and to the anus. It's then insertedinto the anus like a rectal suppository.

Cooling quickly decreases the local blood flow, inflammation and swelling. This relieves the pain, discharge and bleeding. And since Anurex acts directly on the anal canal it is much safer than a chemical or steriod.

The Anurex probe is left in the rectum for six minutes, removed, washed, places back in the Anurex container and then back in the freezer. A dep freezer is too cold. In mild cases, Anurex should be used one daily. For severe cases, it's needed twice a day for two weeks. The best approach is to continue to use Anurex for a few days after the symptoms have gone. The first few times Anures is used it feels quite cold. One mustpersist to take advantage of its soqthing effect.

Anurex gives good results. In a series os 220 patients, 90% were relieved of itching and buring wihin one to two days. It also helps those who say. "I have a leakage that stains my underwear." Small wonder some patients call it their "magic wand."

The best protection agains anusitis is a healthy lifestyle. This mean a high-fibre diet and ample anounts of water that keep bowel movements soft. Soft stools don't irritate the bowel's sensitive lining and they guard against constipation."

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The Finicial Post - Jun 1997

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