DILTIAZEM 4% TOPICAL FOR CHRONIC ANAL FISSURE

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Article Title:	DILTIAZEM 4% TOPICAL FOR CHRONIC ANAL FISSURE
Authors:	C. Duta1, C. Neamtu2*, E. Hordovan1, D. Barjica1, A. Salim1, B. Totolici2
Affiliation:	1„ Victor Babes” University of Medicine and Pharmacy Timisoara, Second Surgical Clinic, Timisoara, Romania 2„Vasile Goldiş” Western University of Arad – Faculty of Medicine, Pharmacy and Dental Medicine, Arad, Romania
Abstract:	. Anal fissure is a relatively common disease in the population. It is estimated that ~ 10-15% of the population is affected by this problem. If an anal fissure healing period is beyond 6 weeks, we can say that it is a chronic anal fissure. Material and method: it is a restrospective study of three years – 2010 – 2012, on 478 patients from Medvarix Clinic in Timisoara. Results: This study demonstrated the efficacy of local topical diltiazem 4%, because 73% of patients with anal fissure who addressed our proctological clinic were cured and 15% of them showed improvement during the follow-up of 18 months. Recurrence after this period was 19% . Conclusions: With this study we want to demonstrate the importance of local topical treatment with diltiazem 4%, as alternative treatment to internal sphincterotomy with a high risk of anal incontinence as demonstrated by several studies.
Keywords:	anal fissure, local, topical treatment, diltiazem
References:	Kirsch J. Anal fissure.WienMedWochenschr 2004;154:69–72. Antropoli C, Perrotti P, Rubino M, et al. Nifedipine for local use in conservative treatment of anal fissures: Preliminary results of a multicenter study. Dis Colon Rectum1999;42:1011–5. Corman M. Anal fissure. In: Corman M, ed. Colon and rectal surgery. Philadelphia, PA: Lippincott-Raven, 1998:206–23. R. Bhardwaj, M C Parker, Modern Perspectives in the Treatment of Chronic Anal Fissures, Annal Royal Collage of Surgeons of England; 2007 July; 89(5): 472–478. Jan Rakinic, Anal Fissure, Clinics in Colon and Rectal Surg. 2007 May; 20(2): 133–137. De Nardi P, Ortolano E, Radaelli G, et al. Comparison of glycerine trinitrate and botulinum toxin-a for the treatment of chronic anal fissure: Long-term results. Dis Colon Rectum 2006;49:427–32. Kassai M, Illenyi L, Horvath OP. Current treatment of anal fissure. Orv Hetil 2001;142:1565–8. Ward, D.I., Miller, B.J., Schache, D.J., Cohen, J.R. – Cut or paste? The use of glyceryl trinitrate paste in the treatment of acute and chronic anal fissure. ANZ Journal of Surgery, 2000, 70:19. Keith, B.K., Kocher, H.M. – Effect of topical glyceryl trinitrate on anodermal blood flow in patients with chronic anal fissures. ANZ Journal of Surgery, 2001, 71: 548. Cundall, J.D., Gunn, J., Easterbrook, J.R. – The dose response of the internal anal sphincter to topical application of glyceryl trinitrate ointment. Colorectal Disease, 2001, 3:259. Utzig, M.J., Kroesen, A.J., Buhr, H.J. – Concepts in pathogenesis and treatment of chronic anal fissurea review of the literature. Am. J. Gastroenterol, 2003, 98:968. Jonas M, Scholefield JH. Anal fissure. Gastroenterol Clin North Am 2001;30:167–81. Dawas, P. – Disappointing results of glyceryl trinitrate ointment in the treatment of chronic fissure-in-ano in a district general hospital. Colorectal Disease, 1999, 1:204 Gupta PJ. Current treatment options for fissure-in-ano. J Med Liban 2004;52:33–8. Gupta PJ. Current trends of management for fissure in ano. Rom J Gastroenterol 2002;11:25–7. Garcia-Granero E, Munoz-Forner E, Minguez M, et al. Treatment of chronic anal fissure. Cir Esp 2005;78: 24–7. McCallion K, Gardiner KR. Progress in the understanding and treatment of chronic anal fissure. Postgrad Med J 2001;77:753–8. Heitland W., Perianal fistula and anal fissure, Chirurg. 2012 Dec;83(12):1033-9. Knight JS, Birks M, Farouk R. Topical diltiazem ointment in the treatment of chronic anal fissure. Br J Surg 2001;88:553–6. DasGupta R, Franklin I, Pitt J, et al. Successful treatment of chronic anal fissure with diltiazem gel. Colorectal Dis 2002;4:20–2. Jonas M, Neal KR, Abercrombie JF, et al. A randomized trial of oral vs. topical diltiazem for chronic anal fissures. Dis Colon Rectum 2001;44:1074–8. Carapeti EA, Kamm MA, Evans BK, et al. Topical diltiazem and bethanechol decrease anal sphincter pressure without side effects. Gut 1999;45:719–22. Jonas M, Speake W, Scholefield JH. Diltiazem heals glyceryl trinitrate-resistant chronic anal fissures: A prospective study. Dis Colon Rectum 2002;45:1091–5. Knight JS, Birks M, Farouk R, Topical diltiazem ointment in the treatment of chronic anal fissure,Br. J. Surg. 2001;88(4):553-6. Medhi B, Prakash A, Upadhyay S, Xess D, Yadav TD, Kaman L., Comparison of observational and controlled clinical trials of diltiazem in the treatment of chronicanal fissure, Indian J Surg. 2011 Dec;73(6):427-31. Griffin N, Acheson AG, Jonas M, et al. The role of topical diltiazem in the treatment of chronic anal fissures that have failed glyceryl trinitrate therapy. Colorectal Dis 2002;4:430–5.
*Correspondence:	Carmen Neamtu Str. Gradinarilor Nr.43 Arad, Romania Mobile: 0723225793 Mail: carmen.neamtu@gmail.com