Premium
Comparison of captopril (0.5%) cream with diltiazem (2%) cream for chronic anal fissure: a prospective randomized double‐blind two‐centre clinical trial
Author(s) -
Ala S.,
Enayatifard R.,
Alvandipour M.,
Qobadighadikolaei R.
Publication year - 2016
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13147
Subject(s) - medicine , captopril , diltiazem , randomized controlled trial , irritation , anal fissure , visual analogue scale , incidence (geometry) , clinical trial , double blind , surgery , anesthesia , placebo , blood pressure , physics , alternative medicine , pathology , optics , immunology , calcium
Aim This study compared the efficacy of topical captopril with topical diltiazem in the treatment of chronic anal fissure ( CAF ). Method Fifty patients aged between 15 and 75 years with CAF were included in a prospective randomized, double‐blind clinical trial. They were randomly allocated to either captopril (0.5%) cream or diltiazem (2%) cream in a dose of 2 cm of cream on the perianal skin every 12 h for 8 weeks. The intensity of pain upon defaecation was evaluated every 10 days using a visual analogue scale. Bleeding on defaecation, pruritus and the presence of perianal irritation were also recorded before and during the trial. Results The average pain scores were lower in the diltiazem group on the 20th and 30th days. From day 40 to the end of the trial the average pain scores of the two groups did not differ significantly. There were no significant differences in bleeding or perianal irritation between the groups, but the incidence of pruritus was considerably higher in the captopril group, and at the end of the trial 45.8% of the patients in this group still suffered from pruritus. Conclusion Topical captopril and diltiazem were found to be equally effective in the management of pain, bleeding and perianal irritation due to CAF , but due to the high incidence of pruritus observed with topical captopril this medication is not recommended for the treatment of CAF .