A COMPARATIVESTUDY OF LATERALSPHINCTEROTOMY AND 2% DILTIAZEM GEL AND LOCAL APPLICATION IN THE TREATMENT OF CHRONIC FISSURE IN ANO

DR.K. LAKSHMANA MURTHY; DR. P RAMBABU

Volume : V, Issue : IV, April - 2016

A COMPARATIVESTUDY OF LATERALSPHINCTEROTOMY AND 2% DILTIAZEM GEL AND LOCAL APPLICATION IN THE TREATMENT OF CHRONIC FISSURE IN ANO

Dr. K. Lakshmana Murthy, Dr. P Rambabu

Abstract :

<p>&nbsp;Anal fissures are commonly encountered in routine colorectal lpractice.Fissure has traditionally been treated surgically .Developments in the pharmacological understanding of the internal anal sphincter have resulted in more conservative approaches towards treatment .In this study we compare symptomatic relief, healing and side effects of topical l2% Diltiazem gel and lateral internal sphincterotomy in the treatment of chronic fissure in ano. Methods:60 patients with chronic fissure in ano we redivided into Diltiazem gel and internal sphincterotomy groups.Patients were followed up at weekly intervals forfour weeks minimum for symptomatic relief and healing. Results: Fissure was completely healed in 23 (88.46%) out of 26 patients treated with 2% Diltiazem gel between 4-8 weeks.Healing was 100% with internalsphincterotomy.Time and duration required for healing of fissure was 5.04weeks in Diltiazemgel group and 3.6weeks ininternalsphincterotomy group.78.26%patients were free from pain after treatment with Diltiazemgel whereas 85.18% patients were free from pain after treatment with internalsphincterotomy. Nopatient had any side effects after Diltiazem therapy. Conclusion: Comparison between Diltiazemgel and internal sphincterotomy did not show any difference in fissure healing and pain relief.No side effects were reported from Diltiazemgel therapy.Topical Diltiazem should be the initial treatment in chronicfissure inano.Internalsphincterotomy should be reserved for patients with relapse and therapeutic failure to prior pharmacological treatment.</p>