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Without enough oxygen, the cells which make up the lining can't grow and repair (heal) the fissure (or tear). A licensed medicine for treating chronic anal fissure in adults (over 18 years of age) is available in the UK: glyceryl trinitrate ointment (also called Rectogesic 4 mg/g Rectal Ointment).
Calcium channel blockers (eg, 2% diltiazem ointment): In 3 systematic reviews (1 to 7 RCTs, 60 to 727 patients), at about 6 weeks, 78% to 82% of patients were healed with CCBs versus 33% to 42% with control; number needed to treat (NNT)=3 (1 of the 3 analyses was not statistically different). 1-3
31 gru 2022 · Anal fissures often heal within a few weeks with appropriate home treatment. Take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soak in warm water for 10 to 20 minutes several times a day, especially after bowel movements.
22 sty 2013 · The Cochrane review (Nelson et al. 2012, assessed as up-to-date November 2011) identified 4 RCTs that compared 2% topical diltiazem with glyceryl trinitrate for anal fissure. Studies lasted 6–8 weeks and used 0.2% glyceryl trinitrate (3 studies, n=200 participants receiving active treatment) or 0.5% glyceryl trinitrate (1 study, n=43) [12].
22 sty 2013 · The medicine is thought to work by helping the ring muscle (sphincter) that goes around the anus (back passage) to relax and allow blood to flow to the lining of the anus (back passage). This aids the healing process and relieves the pain (see 'What is a chronic anal fissure?').
Anal fissure represents one of the most com-mon anorectal problems encountered in practice. An anal fissure is a linear, longi-tudinal tear or split in the epithelial lining of the distal anal canal [1–3]. The commonly accepted definition of anal fissure is: ‘A lin-ear ulcer of the anoderm, distal to the den-
6 gru 2002 · 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.
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