Treatment of fissure in Ano-conservative treatment with diltiazem and surgical treatment with lateral sphincterotomy: Two faces of same coin

Abstract

Background: Fissure in Ano is a most troubling and painful condition that affects a great majority of population world over. It is one of the common reason of bleeding per anus. Though the nature and anatomy of fissure in Ano is quite clear still the method of treating them with optimal clinical results and least pain and inconvenience to the patient is still open to debate. Hence this study is intended to know conservative treatment method and to offer the patient the same, who are not willing for operative procedure. In the present era of evidence based medicine, in order to reduce the need for anesthesia and surgery this study is intended. Methods: The present study was conducted in 100 patients at Department of Surgery who have been clinically diagnosed as chronic fissure in Ano and also who are admitted in surgery ward for surgical treatment. Group – A: 50 patients who are subjected to chemical sphincterotomy with 2% Diltiazem gel used topically. Group – B: 50 patients who underwent Lateral sphincterotomy.Results: In present study 42/50 patients treated with conservative treatment got relief from pain and cured of fissure compared to that with surgical treatment. Hence 84% of patients were not exposed to surgical risk and were cured effectively with conservative treatment.Conclusions: Conclusion drawn from our study is that conservative treatment with Diltiazem very effective in the treatment of chronic fissure in Ano. This method can, not only be offered to the patient who are not willing for operative procedure but also it significantly reduces the need for anesthesia and surgery in many patients.