Randomised Comparison of the Effect of 0.2% Glyceryl Trinitrate and 0.5% Topical Nifedipine in Acute Anal Fissure Treatment

The Effect of Topical Nifedipine versus Diltiazem on the Acute Anal Fissure: A Randomized Clinical Trial

“…17 After medical treatment, anal canal pressure returns to the pre-treatment level, so in medical treatment methods, the recurrence rate is high . 18 In this study, the recurrence rate after 3 months was 16.3% in the nifedipine group and 24.1% in the diltiazem group, which was not statistically different. In the Akıncı et al study, recurrence after 3 months of follow-up in the nifedipine group was 18%.…”

“…In the Akıncı et al study, recurrence after 3 months of follow-up in the nifedipine group was 18%. 18 In Wasfy and colleagues’ study, after 4 months of follow-up, no recurrence was observed in participants with acute fissures who underwent 8 weeks of diltiazem treatment. 9…”

“…Although the exact underlying pathophysiology of anal fissure is not clear, it is a widely held view that sphincter hypertonia following a traumatic injury can lead to increased anal canal pressure and subsequent local ischemia of the anal mucosa. 18 Therefore, therapeutic methods are focused on the reduction of IAS resting pressure to ameliorate local blood circulation in the ischemic area. Calcium ions have a fundamental function in the maintenance of basal IAS tone.…”

“…Symptomatic relief and the healing rate of the nifedipine group were higher than the glyceryl trinitrate group (56% and 86% versus 22% and 64%, respectively). 18 Katsinelos and colleagues showed that treatment with 5% nifedipine for 8 weeks was associated with an 85.2% healing rate in patients with AAF. Headache was reported in 7.4% of patients.…”