The etiology and pathogenesis of anal fissure (AF) is one of the most common causes of severe anal pain yet has never been fully understood. Factors which predispose people to developing AF include diarrhea, constipation, childbirth, medication as well as constant saddle vibration (amongst professional mountain-bikers) and using a jet of water from a bidet-toilet. For many years, it has been ge...

BACKGROUND Topical application of glyceryl trinitrate (GTN) ointment heals chronic anal fissures, providing an alternative to the traditional first line treatment of surgical sphincterotomy. AIMS To determine the most effective dose of topical GTN for treatment of chronic anal fissures and to assess long term results. METHODS Seventy consecutive patients with chronic anal fissure, were rand...

BACKGROUND The principle to avoid surgery for haemorrhoids and/or anal fissure in Crohn's disease (CD) patients is still currently valid despite advances in medical and surgical treatments. In this study we report our prospectively recorded data on medical and surgical treatment of haemorrhoids and anal fissures in CD patients over a period of 8 years. METHODS Clinical data of patients affect...

AIM Comparison of bilateral versus posterior injection of botulinum toxin into the internal anal sphincter for treatment of acute anal fissure. METHODS Forty patients with acute anal fissure were randomly divided into two equal groups. Group 1 was treated by injecting 20 units of botulinum toxin into each side of the internal anal sphincter, and group 2 by injecting 25 units of botulinum toxi...

Lateral sphincterotomy diminishes internal anal sphincter hypertonia and thereby reduces anal canal pressure. This improves anal mucosal blood flow and promotes the healing of anal fissures. However, sphincterotomy can be associated with long term disturbances of sphincter function. The optimal treatment for an anal fissure is to induce a temporary reduction of anal canal resting pressure to al...

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...

BACKGROUND Chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. Reduction of hypertonia favours fissure healing. Temporary reduction in sphincter tone can be achieved by conservative treatment. Surgical sphincterotomy achieves permanent reduction of sphincter hypertonia and is very successful at healing anal fissures, but requires an ope...

An anal fissure is a longitudinal ulcerated area in the vertical axis of squamous lining canal between verge and dentate line, noted 10–15% proctological patients. Present study was aimed to study, acute fissure-in-ano relation clinical diagnosis management at tertiary hospital. hospital based prospective observational conducted patients 18-70 years age ( including males & females ), w...

BACKGROUND The aim of this study was to compare the effect of topical glycerol trinitrate ointment (GTN) with topical diltiazem hydrochloride ointment (DTZ) in the treatment of chronic anal fissure. METHOD Prospectively, 102 patients were treated randomly with either GTN ointment (0.2%) or DTZ ointment (2%) couple of times daily for 12 weeks. RESULTS Forty-five patients (88.2%) in group DTZ...