Conditions of the anal canal and surrounding skin are a common cause of complaint. Topical anal preparations are readily available, easy to apply and often work well. Perianal symptoms are limited to pruritus, bleeding, pain, discharge or a lump. The list of potential causes of these symptoms is very large and ranges from the innocuous to the lethal. Taking the history helps with the differential diagnosis. No patient directs their doctor's attention lightly to such an embarrassing area.
Local transdermal delivery of phenylephrine to the anal sphincter muscle using microneedles
Fissure in ano is a troubling and painful condition that affects a great majority of the population world over. The nature and anatomy of fissure in ano is quite clear, and much is known about the various predisposing and contributing factors that lead to initiation and progression of the disease. The preferred method of treating them, one that results in optimal clinical results and the least pain and inconvenience to the patient, however, has been open to debate. This paper outlines a brief account of the present scenario of different techniques available for the treatment of chronic anal fissure. Medical manipulation of the internal sphincter should be a first-line treatment in anal fissure.
We propose pretreatment using microneedles to increase perianal skin permeability for locally targeted delivery of phenylephrine PE , a drug that increases resting anal sphincter pressure to treat fecal incontinence. Microneedle patches were fabricated by micromolding poly-lactic-acid. Pre-treatment of human cadaver skin with microneedles increased PE delivery across the skin by up to fold in vitro. In vivo delivery was assessed in rats receiving treatment with or without use of microneedles and with or without PE. Resting anal sphincter pressure was then measured over time using water-perfused anorectal manometry.