Establishing the Superiority of Topical Diltiazem over Glyceryl Trinitrate in the Treatment of Chronic Anal Fissure: a Prospective Analytical Study

Abstract

Introduction: Anal fissure is a common ailment of young age group, affecting males and females alike. Traditionally surgery has been the 1st line of treatment but recently the topical agents such as Glyceryl Trinitrate and Diltiazem are replacing the surgical treatment as preferred modality. Objective: The present study was conducted to compare the topical GTN and DTZ in terms of effectiveness, side effects and patient satisfaction. Material and methods: The study was conducted on 50 patients who were divided into 2 groups- Group I and Group II. Group I patients were treated with topical 2% DTZ while Group II patients were put on topical 0.2% GTN. Cases were kept in follow up for 6 weeks and data thus gathered was analyzed. Results: No significant difference was noted in both groups in term of relief in pain, bleeding and fissure healing. However group II patients reported a higher incidence of headache associated with Topical GTN usage, when compared with the Group II patients (p <0.05). Conclusion: Topical Diltiazem is preferred to topical Glyceryl trinitrate as it is better tolerated with a fewer side effects Hence 2% DTZ should be considered as 1st line of therapy for the treatment of chronic anal fissure.