GASTROENTEROLOGY ARTICLE OF THE WEEK
January 27, 2011
ASGE Standards of Practice. The role of endoscopy in patients with anorectal disorders. Gastrointest Endosc 2010;72:1117-1123.
True or False
1. Radiation proctitis is a progressive disease, when found endoscopic treatment is recommended even in the absence of symptoms
2. Incontinence rates of >9% are associated with surgical treatments for fissures
3. Radiation proctitis is mainly an inflammatory process with lymphocytic infiltration of the mucosa and submucosa
4. A nitroglycerin ointment concentration of 0.2% for the treatment of anal fissures is recommended in these guidelines
5. While there is no accepted medical therapy for radiation proctitis, sucralfate topical therapy appears more effective than ASA-based therapies
6. Argon plasma coagulation is the endoscopic therapy of choice and can easily be done without bowel preparation
7. Most fissures appear in the posterior midline, about 20% could be anterior
8. EUS is superior to MRI for evaluation of internal anal sphincter defects, MRI is equal or superior to EUS for external sphincter pathology
9. Topical diluted formalin application to the rectal mucosa can be considered as an alterantive to APC for the treatment of radiation proctitis