Topical treatments for anal fissure

Author/s: 
Fagan, C., Kolber, M. R., Lindblad, A. J.
Date Added: 
January 28, 2023
Journal/Publication: 
Canadian Family Physician
Publisher: 
College of Family Physicians of Canada
Publication Date: 
January 1, 2023
Issue: 
1
Volume: 
69
Pages: 
33
Type: 
Meta-analyses, Reviews, and Guidelines
Format: 
Article
DOI (1): 
10.46747/cfp.690133
PMID (1): 
36693740

RPR Commentary

A summary of the effectiveness of various typical treatments of patients with anal fissures. James W. Mold, MD, MPH

Abstract

Clinical question
How effective are topical treatments (calcium channel blockers [CCBs], nitrates, and vitamin E) for
chronic anal fissures in adults?
Bottom line
Healing rates with topical nitroglycerin are roughly
60% versus 40% with placebo at 8 weeks. Topical
CCBs are at least as good as nitroglycerin, with a
lower risk of headache (7% versus 56%). Based on
1 RCT, topical vitamin E may be superior to nitroglycerin (86% versus 66% healed at 8 weeks).

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