Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial
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 b...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-11-01
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| Series: | Journal of Surgical Specialties and Rural Practice |
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| Online Access: | https://journals.lww.com/10.4103/jssrp.jssrp_13_24 |
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| author | Vinoth Sundaresan Vinothkumar Sadayappan R Kannan Rajendiran T Tirou Aroul |
| author_facet | Vinoth Sundaresan Vinothkumar Sadayappan R Kannan Rajendiran T Tirou Aroul |
| author_sort | Vinoth Sundaresan |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-be6e96b1f28e4c5f89e4fa404b62f54b |
| institution | OA Journals |
| issn | 2772-3143 2772-3151 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Surgical Specialties and Rural Practice |
| spelling | doaj-art-be6e96b1f28e4c5f89e4fa404b62f54b2025-08-20T01:58:45ZengWolters Kluwer Medknow PublicationsJournal of Surgical Specialties and Rural Practice2772-31432772-31512024-11-0153707410.4103/jssrp.jssrp_13_24Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control TrialVinoth SundaresanVinothkumar SadayappanR Kannan RajendiranT Tirou AroulBackground: 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.https://journals.lww.com/10.4103/jssrp.jssrp_13_24chronic fissure in anolidocaine geltopical diltiazemtopical sucralfate |
| spellingShingle | Vinoth Sundaresan Vinothkumar Sadayappan R Kannan Rajendiran T Tirou Aroul Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial Journal of Surgical Specialties and Rural Practice chronic fissure in ano lidocaine gel topical diltiazem topical sucralfate |
| title | Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial |
| title_full | Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial |
| title_fullStr | Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial |
| title_full_unstemmed | Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial |
| title_short | Topical Diltiazem versus Topical Sucralfate and Lignocaine in the Treatment of Chronic Fissure in Ano: A Prospective Randomized Control Trial |
| title_sort | topical diltiazem versus topical sucralfate and lignocaine in the treatment of chronic fissure in ano a prospective randomized control trial |
| topic | chronic fissure in ano lidocaine gel topical diltiazem topical sucralfate |
| url | https://journals.lww.com/10.4103/jssrp.jssrp_13_24 |
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