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Chronic Anal Fissure (chronic + anal_fissure)
Selected AbstractsBotulinum neurotoxin to treat chronic anal fissure: results of a randomized ,Botox vs.ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2004Dysport' controlled trial Summary Background :,Botulinum neurotoxin induces healing in patients with idiopathic fissure. The optimal dosage is not well established. Aim :,To compare the efficacy and tolerability of two different formulations of type A botulinum neurotoxin, and to provide more evidence with regard to the choice of dosage regimens. Methods :,Symptomatic adults with chronic anal fissure were enrolled in a randomized study. The outcome of each group was evaluated clinically, and by comparing the pressure of the anal sphincters before and after treatment. Results :,Fifty patients received injections of 50 units of Botox formulation (group I), and 50 patients received injections of 150 units of Dysport toxin (group II). One month after injection, 11 patients in group I and eight in group II had mild incontinence of flatus. At the 2-month evaluation point, 46 patients in group I and 47 patients in group II had a healing scar. In group I patients, the mean resting anal pressure was 41.8% lower, and the maximum voluntary squeeze pressure was 20.2% lower, than the baseline value. In group II patients, the resting anal pressure and maximum voluntary squeeze pressure were 60.0 ± 12.0 mmHg and 71.0 ± 30.0 mmHg, respectively. There were no relapses during an average of about 21 months of follow-up. Conclusions :,Botulinum neurotoxin may be considered an effective treatment in patients with chronic anal fissure. The efficacy and tolerability of the two different formulations of botulinum neurotoxin were indistinguishable. [source] Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure (Br J Surg 2002; 89: 413,17)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 10 2002N. S. Balaji No abstract is available for this article. [source] Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure (Br J Surg 2002; 89: 413,17)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2002A. G. Acheson No abstract is available for this article. [source] Clove oil cream: a new effective treatment for chronic anal fissureCOLORECTAL DISEASE, Issue 6 2007H. A. Elwakeel Abstract Objective, Anal fissure is a common painful condition affecting the anal canal and causes considerable morbidity and reduction in quality of life. Surgical treatment has been associated with a degree of incontinence in up to 30% of patients. This study discussed the results of clove oil 1% cream in healing of chronic anal fissure. Method, A single-blind randomized comparative trial was setup to compare traditional treatment with stool softeners and lignocaine cream 5% against clove oil 1% cream for 6 weeks. Results, 55 patients were included in this study, 30 patients in clove oil group and 25 patients in control group. Healing had occurred in 60% of patients in clove oil group and in 12% of patients in the control group after 3-month follow up (P < 0.001). Patients in clove oil group showed significant reduction in resting anal pressure and almost all other anorectal manometric pressures compared with patients in control group. Conclusion, Topical application of clove oil cream demonstrated a significant beneficial effect when applied to patients suffering from chronic anal fissure. [source] A prospective randomized trial of diltiazem and glyceryltrinitrate ointment in the treatment of chronic anal fissureCOLORECTAL DISEASE, Issue 3 2003K. Bielecki Abstract Objective The aim of this study was to compare prospectively diltiazem with GTN ointment in the treatment of anal fissure. Patients and methods Of 43 outpatients with chronic anal fissure, 22 patients were randomized to topical diltiazem (2%) ointment and 21 patients to glyceryltrinitrate (GTN) (0.5%) ointment twice daily for 8 weeks. During the course of treatment each patient was seen three times. Side-effects and healing were recorded. Results Healing occurred in 19 of 22 patients treated with diltiazem and 18 of 21 patients were cured with GTN (P = 0.95). Those who were treated with nitroglycerin ointment developed headache and dizzness developed after GTN in 33.3% of cases while no patient had any side-effects after diltiazem. Conclusions Diltiazem and glyceryltrinitrate (GTN) were equally effective in healing anal fissure but the former resulted in fewer side-effects. [source] Treatment of resistant anal fissure with advancement anoplastyCOLORECTAL DISEASE, Issue 6 2002N. J. Kenefick Abstract Objective The primary aim of this study was to assess the outcome of advancement anoplasty in the treatment of chronic anal fissure, resistant to conventional therapy. The secondary aim was to evaluate the anal resting pressure in these patients with resistant fissures. Patients and methods Over a five-year period eight patients (2 male, median age 55 years, range 20,74) with resistant anal fissure were referred from 6 centres. They had endured symptoms for a median of 8 years (range 2,20) and had undergone a median of 2 previous surgical procedures (range 1,3), including lateral sphincterotomy and anal dilatation. Anorectal physiological testing was performed on all patients who then underwent advancement anoplasty. The outcome was analysed retrospectively. Results Pre-operative anorectal physiological testing showed a significantly lowered median maximal anal resting pressure of 42 mm H2O (range 12,72 mm H2O, normal range > 60 mm), P = 0.03. All patients underwent advancement anoplasty. At a median of seven months follow-up (range 2,22) seven of eight patients had healed their fissure and were asymptomatic. The median healing time was four months (range 2,6). Conclusion Patients with chronic anal fissure, resistant to conventional therapy, may be successfully treated by advancement anoplasty. Healing time however, may be prolonged. In this series patients had a decreased anal resting pressure rather than anal hypertonia. [source] | ||||||||||