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Related Experiment Videos

Topical diltiazem and bethanechol decrease anal sphincter pressure without side effects.

E A Carapeti1, M A Kamm, B K Evans

  • 1Department of Physiology, St Mark's Hospital, Northwick Park, Watford Road, Harrow, Middlesex HA1 3UJ, UK.

Gut
|October 13, 1999
PubMed
Summary
This summary is machine-generated.

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Topical diltiazem and bethanechol significantly reduce anal sphincter pressure, offering a promising alternative to topical nitrates for treating anal fissures with potentially fewer side effects like headaches.

Area of Science:

  • Pharmacology
  • Gastroenterology
  • Anorectal Physiology

Background:

  • Topical nitrates effectively treat anal fissures but commonly cause headaches.
  • The internal anal sphincter's tone is regulated by calcium-dependent mechanisms and cholinergic innervation.
  • Calcium channel blockers and cholinergic agonists may offer alternative treatments for anal fissures with reduced side effects.

Purpose of the Study:

  • To evaluate the efficacy of oral and topical calcium channel blockers and a topical cholinomimetic in reducing anal sphincter pressure.
  • To explore potential low-side-effect treatments for anal fissures.

Main Methods:

  • Three studies were conducted on healthy volunteers.
  • Oral diltiazem (60 mg) was administered as a single dose and a four-day regimen (once or twice daily).

Related Experiment Videos

  • Topical application of diltiazem and bethanechol gels in increasing concentrations was investigated.

    • Main Results:

    • A single 60 mg oral dose of diltiazem reduced maximum resting anal sphincter pressure by 21%.
    • Twice-daily oral diltiazem reduced anal pressure by 17%, while once-daily had minimal effect.
    • Topical 2% diltiazem and 0.1% bethanechol gels caused dose-dependent reductions in anal pressure (28% and 24%, respectively), lasting 3-5 hours.

    Conclusions:

    • Topical diltiazem and bethanechol significantly reduce anal sphincter pressure for extended periods.
    • These agents present potential alternatives to topical nitrates for anal fissure treatment.
    • The reduced side effect profile makes them attractive options for managing anal fissures.