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Anal fissure fissure-in-ano is a very common anorectal condition. The exact etiology of this condition is debated; however, there is a clear association with elevated internal anal sphincter pressures. Though hard bowel movements are implicated in fissure etiology, they are not universally present in patients with anal fissures. Half of all patients with fissures heal with nonoperative management such as high fiber diet, sitz baths, and pharmacological agents. When nonoperative management fails, surgical treatment with lateral internal sphincterotomy has a high success rate. In this chapter, we will review the symptoms, pathophysiology, and management of anal fissures.
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Topical nifedipine vs. topical glyceryl trinitrate for treatment of chronic anal fissure
Anal fissure - Australian Prescriber
Dudukgian, H. Why do we have so much trouble treating anal fistula? Blumetti, J. Blumetti, A. Abcarian, F. Quinteros et al.
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RIS file. An anal fissure is a common, mostly benign, condition that can be acute or chronic. The diagnosis is usually made on history and physical examination, but further investigations are sometimes necessary. Primary fissures are usually benign and located in the posterior or anterior position.
Purpose: Nifedipine administered orally or applied topically has been effective for nonsurgical treatment of anal fissure. We compared the efficacy of nifedipine vs. Methods: In a prospective, double-blind trial, 52 patients suffering from chronic anal fissure were randomly and equally allocated to receive either glyceryl trinitrate or nifedipine, both applied topically to the perianal region. The end point of the study was healing within a predetermined period 6 months. Variables assessed included demographic data age, gender , symptoms associated with the fissure, duration of treatment, percentage of healing, untoward effects of treatment, pain scores, duration of follow-up, recurrence, and need for complementary means of treatment.