ABSTRACT
Background: Anal fissure is condition in which there are cut or tear in the distal anal cavity that associated with the spasm of the muscle of the internal anal sphincter. Simply anal fissure can be treated with simple measures through increase fibers intakes, laxatives, in addition to having a lots of drinks and in cases that not respond to these measures we use some topical preparations include CCBs, steroids, anesthetics. Aim: Topical CCBs mostly given for treatment of chronic anal fissures as it consider effective nonsurgical treatment for anal fissure and there are more than one CCBs including diltiazem and nifedipine to be used in treatment of anal fissure therefore this study was done in order to compare between these two drugs in term of their efficacy and tolerability. Method: In this study there are 65 patients was selected and interviewed during their visits to consultation clinics in Thi-Qar and distributed randomly between the two groups (Diltiazem group) and (Nifedipine group) as they use the drugs for 2 months topically for the perianal region the end point of this study was the healing within the predetermined period (3 months) and also made comparison for the tolerability between the 2 groups. Results: The healing rate with Nifedipine topical was higher significantly when compared with Diltiazem topical while in term of tolerability was there are no significant differences between the two groups the most common adverse effects that founded in the two group was perianal itching and burning sensation in the anal area. Conclusion: Availability of more than one topical from of CCBs for treatment of anal fissure needed to be investigated and according to the above results show that superiority for the topical nifedipine over diltiazem in treatment of anal fissure due to the higher rate of healing while in term of tolerability was no significant differences between them.