A Prospective Randomized Trial of Diltiazem Gel and Glyceryl Trinitrate Ointment on Treatment of Chronic Anal Fissure

In this randomized prospective study، 2% - diltiazem topical gel and 0. 03% -GTN ointment were compared in patients with chronic anal fissure. This semi-experimental study consisted of sixty six outpatients (34 females and 32 males) with chronic anal fissure، who referred to the gastroenterology clinic. Patients were randomly classified into two groups. Group A received GTN ointment (0. 03%)، whereas group B was treated with Diltiazem gel (2%). The treatment was administered twice daily for 8 weeks. Healing and side-effects were recorded to be compared after 8 weeks. In group A، the anal fissure was thoroughly healed within 53. 3% of patients، moderately healed for 6. 7% of patients and not healed in 25. 8% of patients. Moreover، side-effects were noted in 15 (46. 9%) patients (P= 0. 482). Two (6. 2%) patients had intolerable headache and discontinued the study، 11 (34. 3%) patients suffered from headache and 2 patients (6. 2%) were reported to have orthostatic hypotension. In group B، healing occurred in 21 (67. 7%) out of 31 patients and 1 (3. 2%) case of headache was noted (P= 0. 0001). The present study has demonstrated that topical diltiazem can be preferable to GTN owing to the absence of side-effects.