DOI: 10.36347/sjams.2019.v07i03.052

Pages: 1124-1128

Anal fissure, a proctologic disease is a common troublesome condition seen by surgeons. It is a Longitudinal tear in the Anoderm distal to the Dentate line associated with pain with or without bleeding per rectum. The treatment focus is on breaking the cycle of pain, spasm and ischemia. Surgical or chemical sphincterotomy (7) are the treatment options. Topical medications avoid surgical complications and also are cost effective. This study was undertaken to know the efficacy of Topical Nifedipine in both acute and chronic fissure in ano as a treatment modality. Pain was the commonest presenting complaint present in 100% of patients. Bleeding per rectum was more common in Chronic Fissure in Ano patients than in acute fissure in ano.The follow up was done at regular intervals which showed relief of pain in 86.67% of acute and 66.66% of chronic patients by 6 months. Bleeding was absent in 90% of acute and 73.33% of chronic patients. Spasm was relieved in 86.67% 0f acute and 70% of chronic patients. Achievement of symptom free period was earlier in acute group (by 6-8 weeks). Healing rate was 86.67% in acute group and 66.66% in chronic group. This study shows chemical sphincterotomy by Nifedipine avoids permanent sphincter division giving good symptom relief with higher healing rates and with lesser side effects. Hence, nifedipine with lignocaine locally is a very good conservative method to be used in the treatment of fissure in ano for both acute and chronic, if strict follow up is done.