title: [Chronic idiopathic anal pain syndrome].
abstract: BACKGROUND
  The study was undertaken to analyse whether intra-anal ultrasound examination, anorectal physiological evaluation, and histopathological examination of patients suffering from chronic idiopathic anal pain presented any common features and to analyse the results of various treatments.
  
  
  METHODS
  Eighteen patients who met the criteria for chronic idiopathic anal pain were studied. Treatment included 0.2% glyceryl nitrate ointment, ultrasound guided injection of botulinum toxin in the intrasphincteric space, analgesics, and colostomy.
  
  
  RESULTS
  Anal physiological examinations were normal in all but one patient. Intra-anal ultrasonography demonstrated abnormalities in 12 patients. Defecography showed in one patient a small distal invagination but was otherwise normal. Glyceryl nitrate ointment had an effect in one of four patients, and botulinum toxin in four of nine. Two patients needed a colostomy for definitive pain relief, and in 12 of the 18 patients the final treatment was analgesics.
  
  
  CONCLUSIONS
  The methods used in this study did not contribute to the understanding of the pathogenesis of chronic anal pain. The treatment is experimental, but injection of botulinum toxin may be tried on the hypothesis that dystonia in the anal sphincter may play a pathogenetic role.
authors.affiliation: Kirurgisk gastroenterologisk afdeling D og ultralydafdelingen, Amtssygehuset i Herlev, DK-2730 Herlev.
authors.forename: John
authors.initials: J
authors.lastname: Christiansen
authors.forename: Eywin
authors.initials: E
authors.lastname: Bruun
authors.forename: Bjørn
authors.initials: B
authors.lastname: Skjoldbye
authors.forename: Kikke Kirsten
authors.initials: KK
authors.lastname: Hagen
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D000700:Analgesics / Q000008:administration & dosage; D001004:Anus Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D001905:Botulinum Toxins / Q000008:administration & dosage; D002908:Chronic Disease; D003125:Colostomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy; D013577:Syndrome; D014463:Ultrasonography
chemical_list: D000700:Analgesics; D001905:Botulinum Toxins; D005996:Nitroglycerin