Limits...
A novel device reduces anal pain after rubber band ligation: a randomized controlled trial.

Lam TJ, Felt-Bersma RJ - Tech Coloproctol (2012)

Bottom Line: Of the remaining 27/36 patients (75 %) who did not notice improvement, 5/36 patients (14 %) found the insertion of the cooler uncomfortable and 1/36 patients (3 %) experienced nausea.No complications occurred during or after the use of the cooler.The 14/50 patients (28 %), who did not use the cooler, had a lower post-banding pain score compared with patients who used the cooler (1.4 vs 6.4; P < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. tj.lam@vumc.nl

ABSTRACT

Background: Anal pain is a well-known sequel of rubber band ligation (RBL). A plastic device, the anal cooler which can be frozen in a freezer, has been developed to reduce anal pain. It contains a mixture of glycols and has a minimum temperature of 4 °C. This study was designed to investigate the efficacy of the anal cooler in pain relief after RBL.

Methods: Between 2009 and 2010, 100 patients who underwent RBL were prospectively randomized into an anal cooler group (n = 50) or a control group (n = 50). The anal cooler group was instructed to use the cooler when they had pain. All patients were asked to keep a pain diary (0 = no pain; 10 = extreme pain), and follow-up was performed after 3-6 weeks.

Results: It was found that 24/50 patients (48 %) in the anal cooler group and 31/50 (62 %) in the control group needed oral analgesics (NS). In total, 36/50 patients (72 %) used the anal cooler. Of these, 9/36 patients (25 %) noticed improvement. Of the remaining 27/36 patients (75 %) who did not notice improvement, 5/36 patients (14 %) found the insertion of the cooler uncomfortable and 1/36 patients (3 %) experienced nausea. No complications occurred during or after the use of the cooler. The 14/50 patients (28 %), who did not use the cooler, had a lower post-banding pain score compared with patients who used the cooler (1.4 vs 6.4; P < 0.001).

Conclusions: Although post-banding pain after RBL is usually mild, the anal cooler seems to relieve anal pain in 25 % of the patients who used the device.

Show MeSH

Related in: MedlinePlus

Anal cooler
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3368112&req=5

Fig1: Anal cooler

Mentions: Of all the non-surgical procedures, RBL seems to be the preferred first-line treatment for internal hemorrhoids [1]. This procedure has been recognized as safe, effective and easy to perform [7]. However, it is often associated with post-banding pain. In the literature, post-banding pain is documented with an incidence between 6 and 51 % [7–11]. In those situations, Sitz baths, mild analgesics and stool softeners are indicated. Unfortunately, the efficacy of those methods to alleviate pain is disappointing. A special device, the anal cooler, has been developed in an attempt to reduce anal pain (Fig. 1). The anal cooler, which can be cooled in the freezer, is a cylindrical-shaped plastic device containing a mixture of glycols and has a minimum temperature of 4 °C.Fig. 1


A novel device reduces anal pain after rubber band ligation: a randomized controlled trial.

Lam TJ, Felt-Bersma RJ - Tech Coloproctol (2012)

Anal cooler
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3368112&req=5

Fig1: Anal cooler
Mentions: Of all the non-surgical procedures, RBL seems to be the preferred first-line treatment for internal hemorrhoids [1]. This procedure has been recognized as safe, effective and easy to perform [7]. However, it is often associated with post-banding pain. In the literature, post-banding pain is documented with an incidence between 6 and 51 % [7–11]. In those situations, Sitz baths, mild analgesics and stool softeners are indicated. Unfortunately, the efficacy of those methods to alleviate pain is disappointing. A special device, the anal cooler, has been developed in an attempt to reduce anal pain (Fig. 1). The anal cooler, which can be cooled in the freezer, is a cylindrical-shaped plastic device containing a mixture of glycols and has a minimum temperature of 4 °C.Fig. 1

Bottom Line: Of the remaining 27/36 patients (75 %) who did not notice improvement, 5/36 patients (14 %) found the insertion of the cooler uncomfortable and 1/36 patients (3 %) experienced nausea.No complications occurred during or after the use of the cooler.The 14/50 patients (28 %), who did not use the cooler, had a lower post-banding pain score compared with patients who used the cooler (1.4 vs 6.4; P < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. tj.lam@vumc.nl

ABSTRACT

Background: Anal pain is a well-known sequel of rubber band ligation (RBL). A plastic device, the anal cooler which can be frozen in a freezer, has been developed to reduce anal pain. It contains a mixture of glycols and has a minimum temperature of 4 °C. This study was designed to investigate the efficacy of the anal cooler in pain relief after RBL.

Methods: Between 2009 and 2010, 100 patients who underwent RBL were prospectively randomized into an anal cooler group (n = 50) or a control group (n = 50). The anal cooler group was instructed to use the cooler when they had pain. All patients were asked to keep a pain diary (0 = no pain; 10 = extreme pain), and follow-up was performed after 3-6 weeks.

Results: It was found that 24/50 patients (48 %) in the anal cooler group and 31/50 (62 %) in the control group needed oral analgesics (NS). In total, 36/50 patients (72 %) used the anal cooler. Of these, 9/36 patients (25 %) noticed improvement. Of the remaining 27/36 patients (75 %) who did not notice improvement, 5/36 patients (14 %) found the insertion of the cooler uncomfortable and 1/36 patients (3 %) experienced nausea. No complications occurred during or after the use of the cooler. The 14/50 patients (28 %), who did not use the cooler, had a lower post-banding pain score compared with patients who used the cooler (1.4 vs 6.4; P < 0.001).

Conclusions: Although post-banding pain after RBL is usually mild, the anal cooler seems to relieve anal pain in 25 % of the patients who used the device.

Show MeSH
Related in: MedlinePlus