Anal Fissure Management

A randomized,prospective,double blind,placebo controlled trial was conducted in the outpatient department of surgery,Chittagong Medical College Hospital over a period of 4 month to see the efficacy of topical application of 0.2% GTN ointment for the treatment of anal fissure.Patient were enrolled by computer generated randomization.Patient and assessor both were completely blind of two groups.All patients were followed at two weeks intervals for assessment of satisfaction,symptoms relief,fissure healing and complication.At the end of study the data was processed and analyzed using SPSS,setting the confidence level at 95%. After data analysis we found that GTN ointment was effective in 85.5% cases with insignificant number of transient complications like headache,pruritus and burning in anal canal.Complications in control arm were also insignificant but healing rate was 25% only.5 patients from the experimental group and 39 patients from placebo treated group were offered lateral internal sphincterotomy.In three patients in experimental group ulcer healed with the use of GTN ointment more than 8 weeks.