Comparison of Topical Glyceryl Trinitrate and Nifedipine in Management of Chronic Anal Fissure

Abstract

Objective: To compare the complete healing of chronic anal fissure by using 2% nifedipine paste and 0.5% glyceryl trinitrate ointment each applied locally for 6 weeks. Study Design: Randomized Controlled Trail. Place and Duration of Study: Surgical Unit-I, Pakistan Railway Hospital Rawalpindi spanning over a period of 06 months starting from March 2011 to August 2011. Materials and Methods: Seventy six patients of chronic anal fissure were included in the study. Non-probability convenience sampling was used for the enrolment of patients. Patients were divided equally into two treatment groups A & B. Group 'A' was treated with topical 2% nifedipine paste and Group 'B' was treated with 0.5% glyceryl trinirate ointment. Patients were asked to come for the follow up after six weeks to look for symptomatic improvement and healing rate. Results: All 38 patients included in the study completed the follow up after 06 weeks of treatment in either group. Three patients from Group B experienced intractable headache and were managed by analgesics accordingly but they went on to complete the treatment. None of the patient in group A had any significant side effect causing any adjustment in the treatment. At the end of 06 weeks of treatment, 28 patients in Group A and 25 in Group B showed complete healing of anal fissure. The overall healing rate was 69.75 %( n=76). There was statistically no significant difference at the end of 06 weeks of treatment (p=0.454). Conclusion: It is concluded that 2% nifedipine paste is as effective as 0.5% GTN ointment in terms of healing of chronic anal fissure.

Keywords

• chronic anal fissure, gtn, nifedipine.