Chronic anal fissure has traditionally been treated surgically. Initial enthusiasm for chemical sphincterotomy has waned because of poor outcomes with glyceryltrinitrate ointment. In this study the use of topical 2% diltiazem enriched with 2% Zinc sulphate ointment has been investigated as an alternative method of chemical sphincterotomy. To evaluate the effectiveness and safety of combined ointment of 2% diltiazem enriched with Zinc sulphate in the treatment of anal fissure, and to analyze the relationship between healing duration of the treatment, and the number of applications. A prospective observational study of 55 patients diagnosed with anal fissure that began treatment with three groups; control group A; using Vaseline ointment (15 cases), group B; (15 cases) topical diltiazem ointment 2%, and group C; (20 cases) using combined ointment diltiazem 2% enriched with Zinc sulphate 2% , between August and December 2012. Diltiazem and zinc sulphate ointment was prepared in the Pharmacy Service. Effectiveness and safety were assessed by regular visits as an outpatient management and a telephone survey conducted with each patient within 8 weeks of treatment, adding it to the patient's clinical records. Variables were analyzed including healing, adverse effects, duration of treatment and number of applications, among others. Follow-up was carried out for up to 3 months until complete recovery of the fissure. A total of 55 patients were included in the study , 50% of anal fissure cases were healed especially group C. Recovery occurred in 15% of patients with anal fissure in group B and in 3% of patients with anal group A. 50 % of patients fissure were cured who underwent treatment for a month or more. Treatment of chronic anal fissures with 2% diltiazem ointment enriched with Zinc sulphate 2% for two months has avoided surgery in nearly 50 % of patients, with few adverse effects.
Key words: Vaseline, Diltiazem, Zinc sulphate, anal fissure
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