Abstract
Background: Fissure-in-ano is a very common problem across the world. The rationale of treating this condition is to reduce the internal anal sphincter tone, thereby relieving the spasm and improving the circulation. This study aims to analyse the various modalities of treatment given for fissure in ano and observe the presentations and tailor the treatment needs of the patient. Methods: This study was done prospectively on 165 patients with fissure in ano in Apollo BGS hospitals Mysore, and patients were treated with Diltiazem gel and Left lateral sphincterotomy when and as needed. Results: 165 patients were prospectively studied, treated with conservative management with Diltiazem gel and left lateral sphincterotomy when and as needed. 134 patients (81.2%) improved and fissure healed and 31 patients (18.8%), whose fissure was not healed were subjected to Left lateral sphincterotomy. Mean time taken for fissure to heal with conservative management was 5.26 weeks and with surgery was 3.41 weeks. Conclusion: Topical Diltiazem gel therapy should be advocated as the first line of treatment and surgery should be reserved for patients with relapse and therapeutic failure of prior pharmacological treatment.
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