PURPOSE: Anal problems due to ingested foreign bodies are rare and usually present as acute anal pain. However, various clinical presentations are possible. This study was performed to identify the diverse manifestations of and the outcomes of treatments for anal diseases caused by ingested foreign bodies. METHODS: Between September 1995 and June 2003, seven patients were treated for anal diseases due to the impaction of ingested foreign bodies in Seoul National University Hospital and Daehang Hospital. We retrospectively reviewed the medical records of those unusual patients. RESULTS: All patients were males, and their mean age was 49.4 yr (range, 37 to 74 yr). The detected foreign bodies were fish bones (n=3), fish fins (n=2), a chicken bone (n=1), and a toothpick (n=1). Four patients had acute anal pain as the primary symptom while two patients presented anal pus discharge, and one patient presented anal bleeding. In the four patients with acute anal pain, the foreign bodies were easily found on digital rectal examination and inspection with anoscopy. Those patients underwent simple removal of the foreign body at the outpatient clinic. In three patients, the foreign bodies were found during surgery for hemorrhoids or fistulas. The two fistulas detected were complex types and needed seton placement. CONCLUSION: Anal problems caused by ingested foreign bodies usually involve acute anal pain, but our results indicate that, in some cases, the anal foreign bodies are also the cause or an aggravating factor in chronic anal disease.
Ambulatory Care Facilities ; Chickens ; Digital Rectal Examination ; Eating ; Fistula ; Foreign Bodies ; Hemorrhage ; Hemorrhoids ; Humans ; Male ; Medical Records ; Retrospective Studies ; Suppuration

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.