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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).
22 sty 2013 · Other studies have found that, on average, about 49 people in every 100 who used GTN had their anal fissure healed, compared with about 36 people in every 100 who used dummy cream or ointment. One of the studies compared diltiazem cream with botulinum toxin injection.
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
22 sty 2013 · Topical diltiazem hydrochloride is not licensed in the UK for treating chronic anal fissure. Topical diltiazem hydrochloride typically comes as a 2% cream or ointment. Topical means that the medicine is applied to the surface of the body, in this case, just inside the anus (back passage).
9 wrz 2013 · The use of topical 2% diltiazem hydrochloride for treating anal fissures by lowering anal sphincter pressure has been explored in multiple clinical trials since 2000[1-5]. Diltiazem hydrochloride, a calcium channel blocker, is well known as an oral treatment for hypertension and angina.
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.
Anal fissures are considered to be acute if they have been present for less than 6 weeks, super - ficial and have well-demarcated edges. Most of the acute anal fissures heal spontaneously or with conservative medical management. Chronic anal fissures (CAF), on the other hand, persist for more than 6–8 weeks and
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