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Article ; Online: Injection of botulinum toxin significantly increases efficiency of fissurectomy in the treatment of chronic anal fissures.

Roelandt, Philip / Coremans, Georges / Wyndaele, Jan

International journal of colorectal disease

2021 Volume 37, Issue 2, Page(s) 309–312

Abstract: Purpose: While acute anal fissures can be treated with topical therapy to reduce sphincter hypertonia (e.g., isosorbide dinitrate, glyceryl trinitrate, diltiazem), chronic fissures may require more invasive instrumental therapy. Currently, the golden ... ...

Abstract	Purpose: While acute anal fissures can be treated with topical therapy to reduce sphincter hypertonia (e.g., isosorbide dinitrate, glyceryl trinitrate, diltiazem), chronic fissures may require more invasive instrumental therapy. Currently, the golden standard remains lateral internal sphincterotomy; however, this carries the long-term risk of faecal incontinence. Fissurectomy can be a valuable alternative, but is less efficient because of absence of correction of underlying hypertonia. In this study, we aim to evaluate the additional effect of injection of botulinum toxin during fissurectomy in the treatment of chronic anal fissures. Methods: A single-centre retrospective analysis of 293 isolated superficial fissurectomies with or without injection of botulinum toxin was performed, with pain relief as primary endpoint. Results: The majority of patients undergoing fissurectomy were women (65%, mean age 45.0 years vs. 35% men, mean age 48.3 years), often because of ventral fissures (30% in women vs. 8% in men). Fissurectomy resulted in resolution of complaints in 81.1%, while additional injection of botulinum toxin resulted in resolution in 90.1% (p < 0.05). Complication rate was identical between the two groups, mainly (flatus) incontinence (4.5% vs 4.9% with botulinum toxin) and post-operative bleeding (1.8% vs 2.5% with botulinum toxin). Conclusion: Injection of botulinum toxin significantly increases the efficiency of fissurectomy in the treatment of chronic anal fissures without additional complications.
MeSH term(s)	Anal Canal/surgery ; Botulinum Toxins, Type A/therapeutic use ; Chronic Disease ; Female ; Fissure in Ano/drug therapy ; Fissure in Ano/surgery ; Humans ; Male ; Middle Aged ; Neuromuscular Agents/therapeutic use ; Retrospective Studies ; Treatment Outcome
Chemical Substances	Neuromuscular Agents ; Botulinum Toxins, Type A (EC 3.4.24.69)
Language	English
Publishing date	2021-11-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-021-04057-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Book ; Thesis: Myogenic control and motility patterns of the human small bowel

Coremans, Georges

1987

Keywords	Gastrointestinal Motility
Size	190 S. : graph. Darst.
Publishing country	Belgium
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Leuven, Kath. Univ., Diss., 1987
HBZ-ID	HT003168269
Database	Catalogue ZB MED Medicine, Health

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Book: Reizdarmsyndrom

Coremans, Georges / Schumann, Christian

Klinik, Diagnose, Behandlung

(Duphar med script ; 12)

1995

Author's details	unter Mitarb. von G. Coremans ... [Red.: Christian Schumann]
Series title	Duphar med script ; 12
Collection
Keywords	Reizcolon
Subject	Colon irritabile ; Spastisches Colon ; Irritables Colon ; Reizkolon ; Spastisches Kolon ; Reizdarm ; Reizdarm-Syndrom
Language	German
Size	108 S.
Edition	1. Aufl.
Publisher	Duphar Arzneimittel GmbH
Publishing place	Hannover
Document type	Book
HBZ-ID	HT006665398
ISBN	3-927661-10-4 ; 978-3-927661-10-3
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Analgesic injection of botulinum toxin in anal fissures is efficient and can be performed safely in patients actively receiving chemotherapy.

Roelandt, Philip / Coremans, Georges / Wyndaele, Jan

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2020 Volume 28, Issue 11, Page(s) 5053–5054

Abstract: Purpose: Injection of botulinum toxin into the internal anal sphincter is a well-documented intervention to reduce anal hypertonia in the treatment of anal fissures. In patients receiving chemotherapy, painful anal conditions are frequent, secondary to ... ...

Abstract	Purpose: Injection of botulinum toxin into the internal anal sphincter is a well-documented intervention to reduce anal hypertonia in the treatment of anal fissures. In patients receiving chemotherapy, painful anal conditions are frequent, secondary to change in bowel habits and reduced immunity. However, injection of botulinum toxin is often not offered due to fear of complications. Methods: In this retrospective longitudinal observational study, performed in a tertiary hospital setting, we analysed patient characteristics, outcome and complication rates of botulinum toxin injection in patients actively receiving chemotherapy. Results: Twenty-six patients were treated with 20-50 IU botulinum toxin while actively receiving chemotherapy because of intractable pain and hypertonia. The fissure was located dorsally in 69% (n = 18) and ventrally in 19% (n = 5), while in 3 patients (12%), no fissure was documented. The majority of the patients (88%, n = 23) had complete (54%, n = 14) or partial (35%, n = 9) relief of pain. In three patients, additional anal pathology developed in the weeks following botulinum toxin injection: thrombosis of grade IV haemorrhoids, perianal haematoma and an intersphincteric abscess. Conclusions: Injection of botulinum toxin in the anal sphincters is a safe and effective analgesic option in patients with anal fissure while actively receiving chemotherapy.
MeSH term(s)	Adult ; Aged ; Anal Canal/drug effects ; Analgesics/administration & dosage ; Botulinum Toxins, Type A/administration & dosage ; Chronic Disease ; Female ; Fissure in Ano/drug therapy ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Muscle Hypertonia/drug therapy ; Neoplasms/drug therapy ; Neuromuscular Agents/administration & dosage ; Pain/drug therapy ; Pain/etiology ; Retrospective Studies ; Treatment Outcome ; Young Adult
Chemical Substances	Analgesics ; Neuromuscular Agents ; Botulinum Toxins, Type A (EC 3.4.24.69)
Language	English
Publishing date	2020-07-25
Publishing country	Germany
Document type	Journal Article ; Observational Study
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-020-05641-4
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 3697: Show issues

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Article ; Online: Prucalopride: the evidence for its use in the treatment of chronic constipation.

Coremans, Georges

Core evidence

2010 Volume 3, Issue 1, Page(s) 45–54

Abstract: Introduction: Chronic constipation is a common condition that is difficult to treat. Existing options for the treatment of patients with different subgroups of constipation are limited. A new efficacious and safe drug is needed to limit the frequently ... ...

Abstract	Introduction: Chronic constipation is a common condition that is difficult to treat. Existing options for the treatment of patients with different subgroups of constipation are limited. A new efficacious and safe drug is needed to limit the frequently observed adverse effects induced by laxatives, to improve general wellbeing and quality of life, and to provide an alternative for enemas or even resectional surgery in patients in whom stimulant laxatives cause disabling adverse effects or fail to increase bowel movement frequency. Aims: The purpose of this article is to assess the current evidence supporting the use of the selective and high affinity serotonin-4 (5-HT(4)) receptor agonist prucalopride in the management of chronic constipation. Evidence review: There are now convincing data from phase II and multicenter phase III randomized, double-blind, placebo-controlled trials that prucalopride treatment results in a clinically meaningful increase in the number of spontaneous complete bowel movements, a reduction of perceived severity of symptoms and improved disease-related quality of life in a significant proportion of patients. There is a rapid onset of the effect and the improvement is maintained for at least 12 weeks. Prucalopride in a dose of up to 4 mg per day appeared generally well tolerated and devoid of serious cardiac events. Adverse events, most frequently headache and nausea, are usually mild or moderate and occur mainly during the first days of treatment. Prucalopride should be used with prudence and with careful assessment of the benefit-risk ratio until more clinical and electrophysiologic data become available, because relatively few patients have been exposed to the drug for long periods of time. Place in therapy: Prucalopride 1-2 mg once daily may be given to patients suffering from chronic constipation for whom laxatives do not provide adequate relief of their symptoms. Patients with severe constipation and slow transit, who frequently develop tolerance to stimulant laxatives, are also eligible for prucalopride treatment.
Language	English
Publishing date	2010-06-15
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520695-3
ISSN	1555-175X ; 1555-175X
ISSN (online)	1555-175X
ISSN	1555-175X
DOI	10.3355/ce.2008.011
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Prucalopride

Georges Coremans

Core Evidence, Vol 2008, Iss Issue

the evidence for its use in the treatment of chronic constipation

2008 Volume 1

Abstract: Georges CoremansDivision of Gastroenterology, University Hospital Gasthuisberg, University ...

Abstract	Georges CoremansDivision of Gastroenterology, University Hospital Gasthuisberg, University of Leuven, Leuven, BelgiumIntroduction: Chronic constipation is a common condition that is difficult to treat. Existing options for the treatment of patients with different subgroups of constipation are limited. A new efficacious and safe drug is needed to limit the frequently observed adverse effects induced by laxatives, to improve general wellbeing and quality of life, and to provide an alternative for enemas or even resectional surgery in patients in whom stimulant laxatives cause disabling adverse effects or fail to increase bowel movement frequency. Aims: The purpose of this article is to assess the current evidence supporting the use of the selective and high affinity serotonin-4 (5-HT4) receptor agonist prucalopride in the management of chronic constipation.Evidence review: There are now convincing data from phase II and multicenter phase III randomized, double-blind, placebo-controlled trials that prucalopride treatment results in a clinically meaningful increase in the number of spontaneous complete bowel movements, a reduction of perceived severity of symptoms and improved disease-related quality of life in a significant proportion of patients. There is a rapid onset of the effect and the improvement is maintained for at least 12 weeks. Prucalopride in a dose of up to 4 mg per day appeared generally well tolerated and devoid of serious cardiac events. Adverse events, most frequently headache and nausea, are usually mild or moderate and occur mainly during the first days of treatment. Prucalopride should be used with prudence and with careful assessment of the benefit-risk ratio until more clinical and electrophysiologic data become available, because relatively few patients have been exposed to the drug for long periods of time.Place in therapy: Prucalopride 1–2 mg once daily may be given to patients suffering from chronic constipation for whom laxatives do not provide adequate relief of their symptoms. Patients with severe constipation and slow transit, who frequently develop tolerance to stimulant laxatives, are also eligible for prucalopride treatment.Key words: prucalopride, 5-HT4 agonist, chronic constipation, laxatives, bowel movements, safety, tolerance, gastric emptying, small bowel transit, colonic transit
Keywords	Medicine (General) ; R5-920 ; Medicine ; R ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; Therapeutics. Pharmacology ; RM1-950 ; DOAJ:Therapeutics
Subject code	610
Language	English
Publishing date	2008-12-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cidofovir: clinical experience and future perspectives on an acyclic nucleoside phosphonate analog of cytosine in the treatment of refractory and premalignant HPV-associated anal lesions.

Coremans, Georges / Snoeck, Robert

Expert opinion on pharmacotherapy

2009 Volume 10, Issue 8, Page(s) 1343–1352

Abstract: Background: Cidofovir, a nucleotide analog with antiviral activity against a broad range of DNA viruses including human papilloma viruses (HPV), is available off label to clinicians.: Objective: To provide a better knowledge of pharmacology and ... ...

Abstract	Background: Cidofovir, a nucleotide analog with antiviral activity against a broad range of DNA viruses including human papilloma viruses (HPV), is available off label to clinicians. Objective: To provide a better knowledge of pharmacology and effects when topically applied. Methods: After reviewing the chemistry, physiology, and animal studies, an overview of clinical studies is provided. Results/conclusions: Cidofovir, as a result of its antiviral and antiproliferative activity and its ability to induce apoptosis, can offer a solution for the treatment of severe recurrent HPV-induced lesions. It can also be used to attempt to treat dysplastic lesions and as an adjuvant treatment. The long-lasting antiviral activity allows infrequent dosing. As a rule, cidofovir applied on the skin is well tolerated, even in long-term treatment. The dose-limiting nephrotoxicity of the drug is not a concern in patients with a glomerular filtration rate within the normal range. Cidofovir has clearly influenced the landscape of refractory and dysplastic anogenital condylomata acuminata and its use has increased over the last decade. However, further controlled clinical trials are needed to assess the role of cidofovir and its derivatives.
MeSH term(s)	Antiviral Agents/therapeutic use ; Anus Neoplasms/drug therapy ; Anus Neoplasms/virology ; Cytosine/analogs & derivatives ; Cytosine/therapeutic use ; Humans ; Organophosphonates/therapeutic use ; Papillomaviridae/isolation & purification ; Precancerous Conditions/drug therapy ; Precancerous Conditions/virology ; Tumor Virus Infections/drug therapy ; Tumor Virus Infections/virology
Chemical Substances	Antiviral Agents ; Organophosphonates ; Cytosine (8J337D1HZY) ; cidofovir (JIL713Q00N)
Language	English
Publishing date	2009-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2001535-5
ISSN	1744-7666 ; 1465-6566
ISSN (online)	1744-7666
ISSN	1465-6566
DOI	10.1517/14656560902960154
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Zs.A 5130: Show issues

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Article ; Online: Impact of endoscopy system, high definition, and virtual chromoendoscopy in daily routine colonoscopy: a randomized trial.

Endoscopy

2019 Volume 51, Issue 3, Page(s) 237–243

Abstract: Background: To improve detection of mucosal lesions during colonoscopy a number of imaging modalities have been suggested, including high definition and virtual chromoendoscopy. Given the theoretical advantage of these new imaging techniques, we aimed ... ...

Abstract	Background: To improve detection of mucosal lesions during colonoscopy a number of imaging modalities have been suggested, including high definition and virtual chromoendoscopy. Given the theoretical advantage of these new imaging techniques, we aimed to investigate their use for the detection of polyps in patients referred for colonoscopy in a large tertiary hospital. Methods: Demographic, endoscopic, and histological data from 1855 consecutive patients undergoing colonoscopy were collected prospectively. Patients were randomly assigned to three endoscopy systems (Fujinon, Olympus, or Pentax) in combination with four modalities: conventional white-light colonoscopy (n = 505), high definition white-light colonoscopy (n = 582), virtual chromoendoscopy (n = 285) and high definition virtual chromoendoscopy (n = 483). Results: The mean adenoma detection rate (ADR) was 34.9 %, and the adenoma per colonoscopy rate (APCR) was 2.1. No significant differences were noted between the three endoscopy systems. Moreover, no differences in ADR or APCR were observed between the four imaging modalities. High definition white-light colonoscopy resulted in a significantly higher detection of sessile serrated adenomas (8.2 % vs. 3.8 %; Conclusions: No significant differences in ADR or APCR between different endoscopy systems, high definition, and/or virtual chromoendoscopy could be observed in routine colonoscopies in the general population. High definition endoscopy was associated with a significantly higher detection rate of serrated adenomas and adenocarcinomas.
MeSH term(s)	Adenocarcinoma/diagnosis ; Adenoma/diagnosis ; Belgium ; Colonoscopy/methods ; Colorectal Neoplasms/diagnosis ; Diagnosis, Differential ; Female ; Humans ; Image Enhancement/methods ; Male ; Middle Aged ; Prospective Studies
Language	English
Publishing date	2019-01-15
Publishing country	Germany
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-0755-7471
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Zs.A 669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 162: Show issues

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Book ; Thesis: Myogenic control and motility patterns of the human small bowel

Coremans, Georges

1987

Author's details	Georges Coremans
Size	190 S, graph. Darst
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Kathol. Univ., Thesis ... Geaggregeerde voor het Hoger Onderwijs--Leuven, 1987
Database	Former special subject collection: coastal and deep sea fishing

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Book: Myogenic control and motility patterns of the human small bowel

Coremans, Georges

1987

Author's details	Georges Coremans
MeSH term(s)	Gastrointestinal Motility ; Intestine, Small/physiology ; Muscle, Smooth/physiology
Language	English
Size	190 p. :, ill.
Publisher	Katholieke Universiteit Leuven, Laboratory of Gastrointestinal Motilit, Center for Gastrointestinal Research, Dept. of Medicine
Publishing place	Leuven, Belgium
Document type	Book
Note	Thesis (geaggregeerde voor het hoger onderwijs in de geneeskunde)-- Katholieke Universiteit Leuven, Leuven, Belgium.
Database	Catalogue of the US National Library of Medicine (NLM)

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