A prospective randomized trial of diltiazem and glyceryltrinitrate ointment in the treatment of chronic anal fissure.

Author(s): Bielecki K, Kolodziejczak M

Affiliation(s): Department Surgery, Medical Centre for Postgraduate Education, Orlowski Hospital, 231 Czerniakowska str. 00-416, Warsaw, Poland. 0303@a-vip.com

Publication date & source: 2003-05, Colorectal Dis., 5(3):256-7.

Publication type: Clinical Trial; Randomized Controlled Trial

OBJECTIVE: The aim of this study was to compare prospectively diltiazem with GTN ointment in the treatment of anal fissure. PATIENTS AND METHODS: Of 43 outpatients with chronic anal fissure, 22 patients were randomized to topical diltiazem (2%) ointment and 21 patients to glyceryltrinitrate (GTN) (0.5%) ointment twice daily for 8 weeks. During the course of treatment each patient was seen three times. Side-effects and healing were recorded. RESULTS: Healing occurred in 19 of 22 patients treated with diltiazem and 18 of 21 patients were cured with GTN (P = 0.95). Those who were treated with nitroglycerin ointment developed headache and dizziness developed after GTN in 33.3% of cases while no patient had any side-effects after diltiazem. CONCLUSIONS: Diltiazem and glyceryltrinitrate (GTN) were equally effective in healing anal fissure but the former resulted in fewer side-effects.