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Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure.
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Surgical versus chemical (botulinum toxin) sphincterotomy for chronic anal fissure: long-term results of a prospective randomized clinical and manometric study.
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Affiliation(s): Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India.
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The type and number of prescribed or nonprescribed medications taken during the postoperative period were recorded.
It includes topical application of glyceryl trinitrate (GTN), diltiazem, nifedipine, and botulinum toxin7; among them, GTN and diltiazem are commonly used in Pakistan.
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When treatment for hypotension was required, it generally consisted of administration of saline or placing the patient in the Trendelenburg position.
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There were 53 females and 44 males with a mean age of 30 years.
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Despite these reports, incontinence is a concern and current opinion is that manual dilatation of the anus for the treatment of anal fissures is not recommended.
Diltiazem caused fewer side-effects particularly headache than glyceryl trinitrate ointment.
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