Anal fissure is characterized by the tearing of the anus and the anal canal. Its primary cause is trauma. This may be a large, hard, and dry stool, childbirth, tightened muscle that opens and closes the anus (anal sphincter), or frequent diarrhea. There are also non-traumatic diseases that can cause anal fissure. One example is Crohn’s disease, which is characterized by the swelling and inflammation in the lining of the digestive tract. This can then cause sores.
A patient suffering from anal fissure will feel pain in the anus, especially during and after bowel movements. There are more symptoms that are associated with anal fissure. These include anal bleeding, itching, and the discoloration of the fecal matter (also known as malodorous discharge). The color of the stool or fecal matter could be tarry, black, maroon, or red.
Anal fissure has some risk factors. These could be chronic diarrhea, straining from bowel movement, constipation, prior anal surgery, Crohn’s disease, ulcerative colitis, and receptive anal intercourse.
Treatment of anal fissure includes taking lots of water and fiber-rich foods. Some of the best sources of fiber are whole-wheat bread, oats and cereals. You also have the usual fruits and vegetables. Others take laxatives, or surgery.
Aside from these, there are also specific ointments and creams to soothe the infected area. Medication include those that reduce pain and inflammation.
2% topical diltiazem hydrochloride cream or ointment for anal fissure is a cream/ointment applied to the exterior area of the affected part of the anus. It has 2% amount of the active ingredient (diltiazem hydrochloride) present in the cream. This allows the ring muscle or sphincter, which goes around the anus, to stimulate the blood to flow to the lining of the anus, making it more relaxed.
There have been several studies on 2% topical diltiazem hydrochloride cream or ointment for anal fissure.
There was one that showed how well the cream worked. In the experiment of 30 adults, the anal fissure was completely treated in the 24 who applied the diltiazem ointment. Though it was only tested to a few people, it proved to work for the majority. Those who used the 2% topical diltiazem hydrochloride cream experienced less pain and discomfort compared to those who did not get any treatment.
There were 7 studies that compared diltiazem cream with GTN. The findings was that the cream worked as well as GTN. Both had the same effect when healing the anal fissure and relieving pain.
Other studies revealed that there are about 49 people in every 100 who had their anal fissure healed using GTN, while there are about 36 people in every 100 who had their anal fissure healed using dummy cream or ointment. One study compared the 2% topical diltiazem hydrochloride cream or ointment with botulinum toxin injection. Both the cream and the botulinum toxin injection had the same effect and healed the anal fissure and removed the pain and discomfort.
2% topical diltiazem hydrochloride cream or ointment for anal fissure may have a few side effects like itchiness and headaches, but they have not been proven to cause major problems.
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