1Asst Prof, Dept of Surgery, Medical College GMERS, Valsad, Gujarat
2Associate Professor, Dept of Surgery, Govt Medical College and SSG Hospital, Vadodara, Gujarat
Use of topical drugs along with stool softeners is a new way for the treatment of chronic anal fissure which avoids the risk of faecal incontinence associated with traditional surgical methods.
To compare efficacy and adverse effects of topical 2% Diltiazem versus topical 0.2% Nitroglycerine in management of chronic anal fissure, in form of Healing of fissure.
Total 85 patients with of chronic fissure in ano were included in the study. Patients were randomized in two groups, first group received topical 2% diltiazem and second group received topical 0.2% nitroglycerine. All patients were advised to take Sitz bath twice daily and after each stools and those patients who had h/o passing hard stool were given laxatives. Healing of fissure considered when complete epithelalisation occurs. Patients details were recorded according to proforma.
The commonest age of presentation in our series was 21–30 years. Males were more affected when compared with female subjects. Pain while passing stool was the commonest symptom in 65 (76.47%) patients. Fissure was common in posterior midline position, found in 76 (89.41%) patients. The mean duration of healing was approx. 6 weeks in Diltiazem group while 6.37 weeks in NTG group. In patients of Nitroglycerine group, out of 42 patients, 59.52% of the patients developed headache which was quite high as compared to Diltiazem group.
Diltiazem with more or less same efficacy with better tolerability can provide better alternative to NTG in patients with anal fissures.
Anal fissure, chemical sphincterotomy, diltiazem, glyceryl trinitrate
