The Role of Diltiazem enriched with Zinc sulphate in Anal Fissure

Chronic anal fissure has traditionally been treated surgically. Initial enthusiasm for chemical sphincterotomy has waned because of poor outcomes with glyceryltrinitrate ointment. In this study the use of topical 2% diltiazem enriched with 2% Zinc sulphate ointment has been investigated as an alternative method of chemical sphincterotomy. To evaluate the effectiveness and safety of combined ointment of 2% diltiazem enriched with Zinc sulphate in the treatment of anal fissure, and to analyze the relationship between healing duration of the treatment, and the number of applications. A prospective observational study of 55 patients diagnosed with anal fissure that began treatment with three groups; control group A; using Vaseline ointment (15 cases), group B; (15 cases) topical diltiazem ointment 2%, and group C; (20 cases) using combined ointment diltiazem 2% enriched with Zinc sulphate 2% , between August and December 2012. Diltiazem and zinc sulphate ointment was prepared in the Pharmacy Service. Effectiveness and safety were assessed by regular visits as an outpatient management and a telephone survey conducted with each patient within 8 weeks of treatment, adding it to the patient\s clinical records. Variables were analyzed including healing, adverse effects, duration of treatment and number of applications, among others. Follow-up was carried out for up to 3 months until complete recovery of the fissure. A total of 55 patients were included in the study , 50% of anal fissure cases were healed especially group C. Recovery occurred in 15% of patients with anal fissure in group B and in 3% of patients with anal group A. 50 % of patients fissure were cured who underwent treatment for a month or more. Treatment of chronic anal fissures with 2% diltiazem ointment enriched with Zinc sulphate 2% for two months has avoided surgery in nearly 50 % of patients, with few adverse effects. [J Intercult Ethnopharmacol 2013; 2(3.000): 173-176