The Efficacy of L-arginine Gel for Treatment of Chronic Anal Fissure Compared to Surgical Sphincterotomy

Eshghi, F

doi:10.3923/jms.2007.481.484

Cited by 5 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most critical mechanisms of l -arginine in the body are to increase blood flow due to the production of nitric oxide and to decrease the time of wound healing (Scibior and Czeczot 2004 ). Previous studies have shown that topical l -arginine gel significantly reduces anal resting pressure, increases anal blood flow, and significantly heals persistent fissure without any side effects (Acheson et al 2003 , 1; Griffin et al 2002 ; Gosselink et al 2005 ; Fariborz 2007 ). However, a small study conducted on eight healthy volunteers showed that oral administration of 15 g l -arginine had no significant positive effect on anal resting pressure (Prins et al 2005 ).…”

Section: Discussionmentioning

confidence: 99%

“…The results of the studies demonstrated that the use of l -arginine gel significantly reduced anal muscle tone in manometric evaluations, and rectal blood flow increased in laser Doppler flowmetry assessments. However, long-term use of topical l -arginine due to the pH of the drug, osmolality, and its effect on sphincter tonicity are still questionable, and its side effects have not been evaluated (Acheson et al 2003 , 1; Griffin et al 2002 ; Gosselink et al 2005 ; Fariborz 2007 ). To date, only a pilot study performed in 2005 examined the effect of 15 g/day oral l -arginine supplementation on eight healthy individuals for seven days via reducing anal pressure, and the results showed that the level of plasma arginine significantly increased, but the anal resting pressures and anodermal blood flow did not show a significant effect (Prins et al 2005 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

l-Arginine is a feasible supplement to heal chronic anal fissure via reducing internal anal sphincter pressure: a randomized clinical trial study

et al. 2022

View full text Add to dashboard Cite

The hypertonicity of internal anal sphincter resting pressure is one of the main causes of chronic anal fissure. Therefore, the aim of this study was to assess the effect of oral administration of l -arginine on the improvement of the anal fissures by relaxing the internal anal sphincter. Seventy-six chronic anal fissure patients (aged 18–65 years) who were referred to Rasoul-e-Akram Hospital, Tehran, Iran from February 2019 to October 2020 participated in this randomized, double-blind, placebo-controlled trial. Participants were allocated into treatment ( l -arginine) and placebo groups. They took a 1000 mg capsule three times a day for 1 month, and then we followed them at the end of the first and third months after the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. The analysis of data showed a significant decrease in bleeding, fissure size, and pain for each group; however, in the L-arginine group was more than the control group at the end of the study ( P values < 0.001). Following that, a significant increase in QoL was seen just in patients treated with l -arginine ( P value = 0.006). In addition, the comparison of anal pressures at baseline and, between groups at the end of the study showed a significant reduction in sphincter pressure in patients treated with l -arginine ( P value < 0.001, = 0.049; respectively). The oral administration of 3000 mg l -arginine can heal chronic anal fissures by reducing internal anal sphincter pressure with more negligible side effects. However, we recommend long-term study with more extended follow-up. Clinical trial registry: IRCT20190712044182N1 at Iranian clinical trials, date: 2019-08-27.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

l-Arginine is a feasible supplement to heal chronic anal fissure via reducing internal anal sphincter pressure: a randomized clinical trial study

et al. 2022

View full text Add to dashboard Cite

show abstract

Non surgical therapy for anal fissure

Nelson

Kurien

Morgan

et al. 2012

Cochrane Database of Systematic Reviews

163

View full text Add to dashboard Cite

show abstract

A systematic review and meta-analysis of the treatment of anal fissure

et al. 2017

View full text Add to dashboard Cite

LIS is superior to non-surgical therapies in achieving sustained cure of fissure. Calcium channel blockers were more effective than GTN and with less risk of headache, but with only a low quality of evidence. Anal incontinence, once thought to be a frequent risk with LIS, was found in various subgroups in this review to have a risk between 3.4 and 4.4%. Among the surgical studies, manual anal stretch performed worse than LIS in the treatment of chronic anal fissure in adults. For those patients requiring surgery for anal fissure, open LIS and closed LIS appear to be equally efficacious, with a moderate GRADE quality of evidence. All other GRADE evaluations of procedures were low to very low due mostly to imprecision.

show abstract

The Efficacy of L-arginine Gel for Treatment of Chronic Anal Fissure Compared to Surgical Sphincterotomy

Cited by 5 publications

References 18 publications

l-Arginine is a feasible supplement to heal chronic anal fissure via reducing internal anal sphincter pressure: a randomized clinical trial study

l-Arginine is a feasible supplement to heal chronic anal fissure via reducing internal anal sphincter pressure: a randomized clinical trial study

Non surgical therapy for anal fissure

A systematic review and meta-analysis of the treatment of anal fissure

Contact Info

Product

Resources

About