Topical diltiazem ointment in the treatment of chronic anal fissure

Abstract

Topical 2 per cent diltiazem ointment used as an agent for chemical sphincterotomy for chronic anal fissure offers significant healing rates but does not have a significant side-effect profile, which may aid compliance to treatment. Early recurrences are common but usually amenable to further chemical sphincterotomy.

Comparison of topical agents minoxidil and diltiazem in medical management of anal fissures: a hospital based study

“…Six of the seven patients with recurrent fissure were treated successfully by repeating DTZ treatment. 17 Our results are in agreement with that of previous similar studies. The minoxidil group had slightly higher rate of pain relief than did diltiazem, but the difference was statistically insignificant.…”

A Comparative Study of Lateral Sphincterotomy and 2% Diltiazem Gel Local Application in the Treatment of Chronic Fissure in A NO

“…Calcium channel blockers like nifedipine and diltiazem have been shown to lower resting anal pressure [10], promote fissure healing and are associated with good healing rate [7,11,12]. They are associated with side effects such as headache and perianal dermatitis [7]. Healing rates of chronic anal fissure in various studies ranged from 47%-80% [3,10,11,13], while that seen in our study is 88.46%.…”

“…Calcium channel blockers like nifedipine and diltiazem have been shown to lower resting anal pressure [10], promote fissure healing and are associated with good healing rate [7,11,12]. They are associated with side effects such as headache and perianal dermatitis [7].…”

“…Chemical sphincterotomy is now the first line of treatment in many centers [7][8][9]. Calcium channel blockers like nifedipine and diltiazem have been shown to lower resting anal pressure [10], promote fissure healing and are associated with good healing rate [7,11,12].…”

Comparison of Observational and Controlled Clinical Trials of Diltiazem in the Treatment of Chronic Anal Fissure

“…All the studies were in English language and published in index journals. An observational study by Knight et al [9] showed treatment with 2% topical diltiazem in 71 patients. It was observed that 75% experienced healing in 2-3 months and in further 2 months 88% experienced healing.…”