PURPOSE Published clinical trials support the use of 0.2 to 0.4 percent nitroglycerin ointment for the treatment of an anal fissure, although no product is yet available in the United States. In 2004, 84,000 prescriptions were written for compounded nitroglycerin ointment. This study was designed to evaluate the quality of extemporaneously compounded nitroglycerin ointment. METHODS Prescripti...

AIM To assess the value of using smooth muscle relaxants drugs and assess the results of the topical use of 2% diltiazem as an alternative to 0.2% nitroglycerin in the treatment of chronic anal fissure (CAF). METHODS Review of the CAF contained in a prospectively collected database of anal fissures including one hundred forty-five patients diagnosed with CAF and treated with standard measures...

OBJECTIVE To determine the efficacy and safety of fissurectomy with posterior midline sphincterotomy in the management of chronic anal fissure in terms of symptomatic relief, complications and recurrence. STUDY DESIGN Observational case-series. PLACE AND DURATION OF STUDY Department of Surgery, Liaquat University Hospital, Jamshoro/Hyderabad, for a period of 3 years from January 2005 to Dec...

herman Villalba, MD, (left) is a resident in the Department of Surgery, los Angeles Medical Center in California. E-mail: [email protected]. Sabrina Villalba, MD, (center) is a resident in the Department of Family Medicine, los Angeles Medical Center in California. E-mail: [email protected]. Maher A Abbas, MD, fACS, fASCRS, (right) is an Assistant Clinical Professor of Surgery at...

INTRODUCTION Anal fissure causes significant morbidity in the population. It is proposed that elevated sphincter pressures may cause ischaemia of the anal lining and this may be responsible for the pain of anal fissures and their failure to heal. When pharmacologic therapy fails or fissures recur frequently, lateral internal sphincterotomy is the surgical treatment of choice. MATERIAL AND MET...

1. Corby H, Donnelly VS, O’Herlihy C, O’Connell PR. Anal canal pressures are low in women with postpartum anal fissure. Br J Surg 1997;84:86-8. 2. Frudinger A, Halligan S, Bartram CI, Price AB, Kamm MA, Winter R. Female anal sphincter: age-related differences in asymptomatic volunteers with high-frequency endoanal US. Radiology 2002;224:417-23. 3. Farouk R. Sphincter-preserving therapy for trea...

AIM To compare surgical and chemical sphincterotomy for treatment of chronic anal fissure. METHODS The 160 patients studied were randomly divided into four equal groups, treated by lateral internal sphincterotomy (group S), local diltiazem ointment (group D), local glyceryl trinitrate ointment (group GTN), or injection of botulinum toxin into the internal anal sphincter (group BT). Anal manom...

BACKGROUND Anal fissure is perpetuated by high sphincter pressures and secondary local ischaemia. Pharmacological approaches include topical nitrates and botulinum toxin (BT) which act to reduce anal pressure. BT lowers anal pressure by preventing acetylcholine release from nerve terminals while topical nitrates act by donating nitric oxide (NO). The aims of the present study were to compare th...

BACKGROUND Anal fissure is a frequent proctologic disease. There are many and various treatments adopted to cure this disease. In this study we applied radiofrequencies to the subcutaneous lateral internal sphincterotomy and we compared the techniques in a randomised trial. METHODS Patients have been randomized in two groups: in group A 18 patients underwent subcutaneous lateral internal sphi...

Introduction: Parikartika is most common ano-rectal disorder. The text of parikartika mentioned in Samhitas. In this disease there are symptoms such as bleeding per rectum, hard stools, burning sensation around anal region. trial, group A (n=30) included Palashadigudavarti, whereas B Diclofenac sodium suppository for administration over (acute fissures). Gandharva haritaki choorna acts laxative...