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

ABSTRACT

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. Randomized Controlled Trail. Surgical Unit-I, Pakistan Railway Hospital Rawalpindi spanning over a period of 06 months starting from March 2011 to August 2011. 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 and 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. 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]. It is concluded that 2% nifedipine paste is as effective as 0.5% GTN ointment in terms of healing of chronic anal fissure