Current treatment of chronic anal fissure

Abstract EN

This is a prospective study to test the hypothesis that topical isosorbide dinitrate (Isordil) is the best first line of treatment of a chronic anal fissure.

This study was done in the outpatient clinic of Sulaimani Teaching Hospital, Sulaimani, Iraq, from the 1st Dec.

2000 through 30th May 2002.

There were 65 cases of chronic anal fissure treated with 0.5% Isordil ointment and reviewed at 2, 4, 6 and 12 weeks to assess the symptoms, side-effects, fissure healing and patient acceptance.

The age range was 2-65 years with mean age of 31.2years, and female : male was 1.4:1.

At 12 weeks 80 % of patients had no fissure.

In 20% the treatment was unsuccessful.

At 6 months follow-up there was 2.5 % recurrence.

The prevalence of headache was 46.1% on commencing treatment with 12.3 % headache-related noncompliance.

The cost of treatment with this new method was 12 ID for 8 weeks while it was 36 ID for the same period of traditional way of treatment.

We conclude that medical sphincterotomy with 0.5 % Isordil ointment is a feasible, cost-effective method of treatment of chronic anal fissure with high patient acceptance and satisfaction.