Analysis And Comparative Study Of Topical Conservative Medication Versus Operative Management In Patients Of Anal Fissure
DOI:
https://doi.org/10.48165/ijabms.2022.243810Keywords:
Fissure in ano, site of fissure, pain relief, Nitroglycerin, DiltiazemAbstract
Introduction:Anal fissures or anal ulcers are considered one of the commonest causes of severe anal pain. Surgical techniques like manual anal(lords) dilatation or lateral internal sphincterotomy, effectively heal most fissures within a few weeks, but may result in permanently impaired anal continence. This has led to the research for alternative non-surgical treatment AIMS AND OBJECTIVES:The present study comprises the comparative study of 2% Diltiazem gel,0.2% Glyceryl Nitrate,2% lignocaine jelly application and need of surgical intervention in the treatment of chronic fissure in ano.MATERIALS AND METHODS:This is a prospective study of fissure in ano during the period from September 2020 to September 2021 in Sheth Lallubhai Gordhandas Municipal General Hospital, Ahmedabad. Clinical Data of admitted patient were collected by their detail history after stabilizing the patient, clinical examination with appropriate investigations. OBSERVATION AND DISCUSSION: Anal fissure is a very common problem across the world. It causes considerable morbidity and adversely affects the quality of life. Therefore appropriate treatment is mandatory.In this study the commonest age group affected was 31-40 years age group (40%) and least affected were 51-60 years age group The incidence of fissure in males was slightly greater than females with Male Female ratio being 2.2: 1 in our study. CONCLUSION: Propper clinical examination and appropriate investigations helps in management of patient either operative or non-operative which leads successful treatment in these patients.
References
Jonas Marion, Scholefield J.H., Anal fissure and chemical sphincterotomy. Taylor I., Johnson C.D., Recent advances in Surgery. Churchill Livingstone, 24th Edition, 2001, pg. 115.
John Goligher, Anal Fissure, John Goligher, Surgery of the Anus, Rectum & Colon. AITBS, 5th Edition, 1992, pg.150.
J. S. Knight, M. Birks, R. Farouk, Topical Diltiazem ointment in the treatment of chronic anal fissure. British Journal of Surgery.2001; 88 (4): pg. 553-556.
DasGupta R, Franklin I, Pitt J, Dawson PM. Successful treatment of chronic anal fissure with diltiazem gel. Colorectal disease. 2002 Jan;4(1):20-2.
Marion Jonas, William Speake, John H. Scholefield, Diltiazem heals Glyceryl trinitrate resistant chronic anal fissures: a prospective study. Diseases of the colon and Rectum. 2002; 45 (8): 1091-1095.
U. K. Srivastava, B. K. Jain, Praveen Kumar, Yusuf Saifee, A comparison of the effects of Diltiazem and Glyceryl trinitrate ointment in the treatment of chronic anal fissure: a randomized clinical trial. Surgery Today. 2007; 37 (6): 482-485.
E. Carapeti, M. Kamm, B. Evans, R. Phillips, Topical Diltiazem and Bethanechol decrease anal sphincter pressure and heal anal fissures without side effects. Diseases of the Colon and Rectum. 1999; 43 (10): 1359-1362.
I. T. Khubchandani, J. F. Reed, Sequelae of internal sphincterotomy for chronic fissure in ano. British Journal of Surgery. 1989; 76 (5): 431-434.
John Goligher, Surgical Anatomy and Physiology of the Anus, Rectum and Colon, John Goligher. Surgery of the Anus, Rectum and Colon, AITBS, 5th Edition, 1992, pg. 7.
Gray's anatomy. P. L. Williams, R. Warwick, M. Dyson, L. H. Bannister. 37th ed. Pg. 1598
Lee McGregor, The Large Bowel and Anal Canal, Synopsis of Surgical Anatomy, Decker G.A.G. Varghese Publishing House, 1999, pg. 48.
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Copyright (c) 2022 Ravi V. Satasia, Lakir Patel, Kuldeep Vanvi, Jaykumar Patel, Aarsh Panchal, Aimanhusen M. Payala
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