Topical diltiazem and anal fissures

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Background: Chronic anal fissure has traditionally been treated surgically. Initial enthusiasm for chemical sphincterotomy has waned because of poor outcomes with glyceryl trinitrate ointment. In this study the use of topical 2 per cent diltiazem ointment has been investigated as an alternative method of chemical sphincterotomy. Methods: A prospective assessment of 71 consecutive patients with a chronic anal fissure treated with 2 per cent topical diltiazem ointment for a median duration of 9 range weeks was performed. Results: Fifty-one patients 75 per cent experienced healing of the fissure after months of treatment with topical diltiazem.
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Topical diltiazem ointment in the treatment of chronic anal fissure

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Diltiazem Ointment for Anal Fissures | Pavilion Compounding Pharmacy

The content of this evidence summary was up-to-date in January Diltiazem hydrochloride is a calcium channel blocker and vasodilator. It increases blood flow to smooth muscles and relaxes muscle tone. Oral preparations of diltiazem hydrochloride are licensed in the UK to treat angina and hypertension. Topical diltiazem hydrochloride is not licensed in the UK for treating chronic anal fissure or any other indication.
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Anal fissure

RIS file. An anal fissure is a common, mostly benign, condition that can be acute or chronic. The diagnosis is usually made on history and physical examination, but further investigations are sometimes necessary. Primary fissures are usually benign and located in the posterior or anterior position. Secondary fissures are lateral or multiple and often indicate a more serious underlying pathology.
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Doctors commonly prescribe diltiazem to treat high blood pressure and to control the type of chest pain known as angina. Many doctors also prescribe diltiazem-ointment for anal fissures, an uncomfortable condition suffered most often by infants and middle-aged adults. Both conditions can cause discomfort and bleeding.
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