Effect of topical nifedipine in treatment of chronic anal fissure

Abstract

Chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. Reduction of hypertonocity is a special treatment for fisssure healing. For this purpose chronic anal fissure were conventionally treated by anal dilatation or by lateral sphincterotomy. However, both of these methods may cause a degree of incontinence in some patients. The uptake of medical therapies that create a reversible chemical sphincterotomy has recently become widespread. The aim of this study is to assess the effectiveness of nifedipine in heling anal fissure, a calcium channel blocker that reduces sphincter pressure. An observational study conducted with 100 patients of chronic anal fissures treated with 0.3% nifedipine and 1.5% lignocaine. A net 52(52%) patients got there fissures healed with nifedipine. Remaining 48(48%) patients underwent surgery and there fissures healed with out complication. 4(4%) patients reported mild head ache with nifedipine use. Even though significant number of fissures heal with nifedipine recurrence is common. Another finding is low complication rate with nifedipine.