1. High fiber foods, warm sitz baths, stool softeners (if necessary), and daily application of 1% hydrocortisone cream to the fissure should be recommended. These simple measures may heal acute anal fissures within 3 weeks in 90% of patients.

2. Lateral partial internal sphincterotomy is indicated when 4 weeks of medical therapy fails. It consists of surgical division of a portion of the internal sphincter, and it is highly effective. Adverse effects include incontinence to flatus and stool.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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