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Related Experiment Videos

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

E A Carapeti1, M A Kamm, R K Phillips

  • 1St Mark's Hospital, London, United Kingdom.

Diseases of the Colon and Rectum
|October 29, 2000
PubMed
Summary
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Topical diltiazem and bethanechol effectively heal chronic anal fissures by reducing anal sphincter pressure. These treatments offer a side-effect-free alternative to topical nitrates, improving patient outcomes.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pharmacology

Background:

  • Topical glyceryl trinitrate is used for anal fissure healing but causes headaches.
  • Calcium channel blockers and cholinomimetics can lower anal sphincter pressure.

Purpose of the Study:

  • To investigate the efficacy of topical diltiazem and bethanechol in treating chronic anal fissures.
  • To assess the impact of these agents on anal sphincter pressure and pain.

Main Methods:

  • Two studies involving 15 patients each with chronic anal fissure.
  • Treatment with 2% diltiazem gel or 0.1% bethanechol gel for eight weeks.
  • Assessment included anal manometry, laser doppler flowmetry, clinical examination, and pain scores.

Main Results:

Related Experiment Videos

  • Fissure healing occurred in 67% with diltiazem and 60% with bethanechol.
  • Significant reductions in pain scores and maximum resting sphincter pressure (MRP) were observed for both treatments.
  • No headaches or other side effects were reported.

Conclusions:

  • Topical diltiazem and bethanechol are effective in healing anal fissures.
  • Both agents significantly reduce anal sphincter pressure and pain without adverse effects.
  • These treatments represent a viable alternative to topical nitrates for anal fissure management.