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Sanjeew Kumar Chowdhary, Kuldeep Raj Sarangal


Introduction: Pain during & after defecation is one of commonest symptom in surgical OPD. These patients are diagnosed with either acute or chronic anal fissure. Traditionally anal fissure is treated surgically. The physiological functioning of internal sphincter is well understood and hence medical treatment using 2% Diltiazem cream for local application should be tried. In this study, we analyze symptomatic relief, pain relief, healing of fissure with use of 2% Diltiazem twice a day locally.

Material & Methods: This trial includes 72 patients divided into two groups of 36 patients each of acute & chronic anal fissure. Both groups were started with 2% Diltiazem cream locally twice a day for 6 weeks. Both the groups were fortnightly examined for symptomatic relief.

Results: Anal fissure gets completely healed in 85% patients with acute anal fissure whereas chronic anal fissure healing rate was 65%. The non healed fissure patients were further treated for 2 weeks & successful healing rate increases to 90% in acute anal fissure & 80% in chronic fissure. Rest of the patients were taken for excision of fissure & lateral sphincterotomy.

Conclusion: Local application of 2% Diltiazem per anal can be opted as initial therapy for acute & chronic anal fissure & those chronic fissure not responding can be taken up for surgery.


Acute anal fissure, Chronic anal fissure, Lateral sphincterotomy, Fissurectomy, Anal fissure, Diltiazem cream.

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