A COMPARATIVE STUDY OF LATERAL SPHINCTEROTOMY AND 2% DILTIAZEM GEL LOCAL APPLICATION IN THE TREATMENT OF FISSURE IN ANO

Abstract

troduction: Anal ssure is a non-healing linear tear in the distal anal mucosa below the dentate line and is a painful entity.Fissure in ano is a common proctologic disease affecting both men and womenparticularly young.They require surgery like manual anal dilation or lateral internal sphincterotomy which heal the ssure in more than 90% cases but with a signicant risk of impaired anal continence. Newer non surgical therapies such as topical 2% diltiazem gel, have shown good efcacy without impairing anal continence. The aim of the study is to compare the AIMefcacy of outcome of Lateral Sphincterotomy Versus 2% Diltiazem gel in the treatment of chronic ssure in ano. 70 Material and Methods: patients diagnosed with ssure in ano were randomly divided into 2 %Diltiazem and lateral sphincterotomy groups. Patient were followed up at regular interval for symptomatic relief and healing of ssure. Less 89.4% patients Result: in diltiazem group and 100% of patients in lateral internal sphicterotomy group ssure healed completely between 4-8 weeks. In the diltiazem group pain relief was fairly good. 42 patients (89.4%) had pain relief at the end of 14 weeks. But the pain relief in lateral internal sphincterotomy group was excellent with 100% patients having complete pain relief by 8 weeks. Mild headache was experienced with diltiazem patients.1 patient complained of atus incontinence with lateral internal sphincterotomy. We conclude that lateral sphincterotomy is the gold standard t Conclusion: reatment for the ssure in ano but chemical sphincterotomy using 2% topical diltiazem gel can be considered a good second line treatment option in those unt for surgery or for those not willing for surgery