ANOKRYO® 

    

ANOKRYO®

The low temperature rod and dilator for the treatment of hemorrhoids and their complications.

ANOKRYO® is helpful for the following symptoms:

• hemorrhoids (1st and 2nd degree)
• acute anal fissures
• pain relief
• inflammations
• bleeding
• itching
• accompanying constipation
• anal sphincter spasm
• anal symptoms during pregnancy & lactation

ANOKRYO^® : combining low temperature with dilatation offers an effective mode of treatment to safely and rapidly alleviate the patient's symptoms and accelerate healing. This is achieved by cold application at temperatures of -15°C and dilatation to 15 mm with the ANOKRYO®-rod. The duration of a single treatment is 5-10 minutes and should commence 1-3 times daily. The use of low temperature application and dilatation in treating anal conditions is gaining popularity because it is effective, there are no untoward effects and is most suitable for home use 

ANOKRYO® can be reused as often as desired.

The product contains no harmful ingredients, is odourless, hygienic and does not stain.

Side effects are not known.

Also suitable for self-application by the patient in the home environment.

 

Usage information

Application fields / indications

• hemorrhoids (1st and 2nd degree)
• acute anal fissures
• perianal thrombosis
• postoperative pain in the anal area, in cryptitis / papillitis and after radiation treatments
• itching
• anal sphincter spasm with accompanying constipation
• anal symptoms during pregnancy and lactation

The rod reaches its lowest temperature of -15°C after approx. 1-2 hours of storage in the freezer. To ensure hygiene, the rod should always be stored in its case (without the lubricant gel). The rod is then lubricated with a water soluble lubricant and is subsequently inserted into the anal canal for 5-10 min. After cleaning and disinfection the rod is once again stored in its case in the freezer.

ANOKRYO® can be used repeatedly and contains no harmful contents, is odourless, hygienic and causes no staining.

Detailed Usage information

1. The rod reaches its lowest temperature of – 15 °C after two hours of storage in the freezer. To ensure hygiene, the rod should always be stored in its case (without the lubricant gel).
2. Lubricate the rod evenly with gel especially at the tip to ensure smooth insertion. Please use only water-soluble lubricants as ANOKRYO® gel.
3. Carefully insert the rod while laying on the left side with the knees flexed and muscles relaxed. The rod should remain inserted for ten minutes. Within minutes, the temperature of the mucous membranes drops leading to immediate relief of pain, cessation of bleeding and reduction of swelling due to constriction of the blood vessels. Insertion can be painful when anal fissures are present and should be performed slowly and in a gentle manner. Relief of pain and healing is initiated by dilatation.
4. Cleaning of the rod with soap and water as well as routine disinfections is simple. After cleaning, the rod should once again be placed in the freezer.
5. Treatments should commence twice daily. In severe conditions the rod may be applicated once every hour. There are no untoward effects. The initial possibly uncomfortable feeling of coldness is not harmful. The rod does not have to be removed during this period of discomfort.

 

Contraindications / side effects

No untoward effects of ANOKRYO® application are known.

 

Please download the ANOKRYO® flyer here:

Basic help in treating proctologic disorders

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Dr. (syr) M.K. Koudaimi und Dr. F. Beersiek

The anal fissure

Conservative Treatment

Dept. of Surgery, Ev. Hospital LUTHERHAUS, Academic Teaching Hospital of the University of Essen

Anal fissure is a common disorder of uncertain aetiology. The lesion typically presents as a longitudinal tear of ovoid ulcer in the squamous epithelium of the anal canal, occurring most often dorsally at 6 o'clock in the lithotomy position. Anterior fissures are the exception. Fissures are most frequently seen in young to middle-aged adults although some are occasionally seen in children.

The chief complaint is pain characteristically occurring with or shortly after defecation. The pain may be extremely severe if stools are hard. Bleeding and pruritus are additional symptoms often present.

The typical history and the uniform presence of increased intra-anal pressure allow prompt diagnosis. Other painful anal conditions such as herpetic and syphilitic ulcer, perianal thrombosis, proctitis, and anal carcinoma must be excluded in the differential diagnosis.

The principle common to both conservative and surgical treatment is the lowering of intra-anal pressure. Maximal sphincter dilatation and subcutaneous lateral sphincterotomy are well-recognized modes of treatment and have been very effective.

Options diverge on the efficacy of more conservative dilatation methods. When dilatation is performed by the patient themselves, the method requires a high degree of compliance since the procedure may be rather painful at the beginning of treatment.

Bearing this problem in mind we have considered a new approach to anal dilatation in combination with the anesthetizhing effect of low temperatures. A dilatator measuring 15mm in diameter was developed which can be cooled to -15° Celsius.

The well known pain-effect of low temperatures generally allows the patient to easily insert the dilatator. The pain/sphincter spasm cycle can thus be interrupted.

The fluid inside of the dilatator is unique in that low temperature duration in maximal and the rate of temperature equilibration therefore being gradual.

The reactive hyperaemia occurring when tissue temperatures approach normal appears to facilitate fissure healing.

Materials and Methods

From December 1990 to July 1992, 37 patients with anal fissures were treated as outpatients at our hospital with the -Rod cooled to -15° C- Self-insertion of the rod was the sole mode of treatment. There were no other treatment adjuncts. The 15oC rod was inserted in the lateral position and left in place for 5 minutes. Patients performed dilatation twice daily. To facilitate insertion, a water-soluble lubricant was applied. The Viscosity of the lubricant is not altered by the low temperatures.

The patient group consisted of 20 males and 17 females. The average was 41.4 years and was relatively high. The distribution of fissure locations is shown in Fig. 1. Accordingly, 27 patients had posterior fissures, 9 anterior, 1 left lateral, and 2 patients had both an anterior and 1 posterior fissure.

All 37 patients complained of pain during and after defecation. Pain duration ranged from minutes to hours. 15 patients reported a slight amount of bright red blood, 4 patients complained of intensive pruritus. The duration of symptoms ranged from two days to one year with 64 days being the average

Ergebnisse
All 37 patients were seen in our outpatient clinic during the treatment period and were examined upon completion of the treatment period. Treatment duration varied highly and ranged from 3 days to 32 days with 15, 3 days being the average.
Pain subsided on the average after 4 days of treatment. Healing of the fissure was seen in 33 patients after an average treatment of 15, 3 days.

Three fissures failed to heal and one patient was lost to follow-up. The three fissures failing to heal were treated subsequently by lateral sphincterotomy

Discussion

Anal dilatation in combination with the anesthetizing effects of low temperatures is an effective means of treating the pain in anal fissures.

The discomfort and complications associated with surgical treatment can be prevented by this mode of treatment. The anesthetizing effect of the rod cooled to -15° C allows patients to insert the dilatator themselves with minimal pain. This fact has accounted for the general acceptance of this method by patients.

Patients with other painful anal conditions such as perianal thrombosis benefit from the dilatation with the low-temperature -Rod.

Treatment of anal fissures on an outpatient basis by this efficacious and economic method has proven most valuable in conservative management.

Adress:
Dr. med. (syr). M. Kamal Koudaimi, Evangelisches Krankenhaus Lutherhaus GmbH, Hellweg 100, 45276 Essen

Personal data:
Born 11.12.1946 in Damaskus/Syrien, married, 4 children

Vocational career:
Study in Damascus as well as afterwards 2 years activity in the Dermatologi department of the university clinic, since 1974 for specialist training in Germany. From 1975 to 1982 activity in the surgery with 1 ½ years neurosurgery, 1983 specialist for surgery.

Current occupation:
Since 1983 senior physician of the general-surgical department of the Luther hospital in meals under the direction of Professor F. Beersiek.

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