Nov 17

Crohn’s and Colitis UK kindly recognised the work that we have done at the L&D in this September Member of the Month summary

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Nov 12

Anal fissures are painful splits in the lining of the anus. This typically occurs with straining and stretching, but can be associated with IBD.

Treatment options fall into 3 main categories.

1) Stool softening – High fluid and soluble fibre intake +/- Osmotic laxatives eg. Movicol

2) Muscle relaxants – Diltiazem 2% ointment bd + GTN 0.4% ointment bd (Rectogesic)

3) Analgesics – Proctosedyl (cinchocaine 0.5%) ointment bd or Xyloproct (lidocaine 5%) ointment bd

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Nov 12

Tacrolimus can be used in refractory IBD

It is administered orally at a dose of 0.1 mg/kg body weight/day (e.g. 10mg for 100kg man)

The dose may need to be adjusted in order to achieve an optimum serum trough levels of 5–10 ng/ml

The rule of thirds seems to apply – 1/3 fail and need surgery, 1/3 develop side-effects, and 1/3 respond but not all achieve remission

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