Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial

Abstract Background: Chronic anal fissure is the most prevalent anorectal disorder, characterized by linear or oval ulcers in the anal canal's squamous epithelium. Although lateral sphincterotomy stands as the gold standard for treatment, chemical sphincterotomy with calcium channel blockers, n...

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Bibliographic Details
Published in:Journal of Surgical Specialties and Rural Practice Vol. 5; no. 3; pp. 70 - 74
Main Authors: Sundaresan, Vinoth, Sadayappan, Vinothkumar, Rajendiran, R Kannan, Aroul, T Tirou
Format: Journal Article
Language:English
Published: India Wolters Kluwer - Medknow 01.09.2024
Medknow Publications and Media Pvt. Ltd
Wolters Kluwer Medknow Publications
Edition:2
Subjects:
Anal fissure
Calcium channels
Care and treatment
chronic fissure in ano
Clinical trials
Diltiazem
Gastrointestinal diseases
Lidocaine
lidocaine gel
Medical colleges
Nitrates
Original Article
Pain
Sucralfate
topical diltiazem
topical sucralfate
Chronic fissure in ano
lidocaine gel
topical diltiazem
topical sucralfate
ISSN:2772-3143, 2772-3151
Online Access:Get full text
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Summary:Abstract Background: Chronic anal fissure is the most prevalent anorectal disorder, characterized by linear or oval ulcers in the anal canal's squamous epithelium. Although lateral sphincterotomy stands as the gold standard for treatment, chemical sphincterotomy with calcium channel blockers, nitrates, and botulinum toxins is favored in the initial stages to avoid surgical side effects. Aim and Objectives: The goal is to assess the efficacy of topical diltiazem in treating chronic fissure in ano, particularly its impact on pain, bleeding, discharge, recurrence rates, and healing compared to the lignocaine-sucralfate combination. Materials and Methods: A prospective, randomized controlled study was conducted at Mahatma Gandhi Medical College and Research Institute, Puducherry, from October 2014 to April 2016, involving 100 cases. Subjects were divided into two groups: Group A received topical 2% diltiazem and Group B was treated with 2% lignocaine and 7% sucralfate. Both groups followed a regimen including a high-fiber diet, sitz baths, and laxatives, with follow-ups at 2, 4, 6 weeks, and 6 months to evaluate treatment outcomes. Results: Significant improvements were noted in Group A, with pain reduction from a mean of 6.48 to 0.48 by the 6th week. Both groups saw enhanced healing rates and reductions in symptoms, with Group A exhibiting a lower recurrence rate, indicating the superior efficacy of 2% diltiazem. Conclusion: Topical 2% diltiazem is more effective in treating chronic anal fissure than the combination of 2% lidocaine gel and 7% sucralfate, offering better pain management, healing rates, and lower recurrence, making it a preferred treatment option.
ISSN:2772-3143
2772-3151
DOI:10.4103/jssrp.jssrp_13_24