Volume 29, Issue 4 (Avicenna Journal of Clinical Medicine-Winter 2023)                   Avicenna J Clin Med 2023, 29(4): 220-224 | Back to browse issues page

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Notash M, Seyedsadeghi M, Karimi S, Zandian H. Evaluation of the Efficacy of Topical Hydrocortisone in the Treatment of Anal Fissure in Patients Undergoing Pharmacological Treatment. Avicenna J Clin Med 2023; 29 (4) :220-224
URL: http://sjh.umsha.ac.ir/article-1-2576-en.html
1- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
2- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran , dr.mirsalimseyedsadeghi@gmail.com
3- Department of Health Policy, School of Medicine, Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
Abstract:   (1245 Views)
Background and Objective: Anal fissure can be associated with trauma caused by passing hard stools or prolonged diarrhea. The present study aimed to determine the effectiveness of topical hydrocortisone in the treatment of anal fissures in patients under medical treatment referred to Fatemi Hospital and Kausar Clinic of Ardabil Medical Sciences, Ardabil, Iran, in 2019.
Materials and Methods: In this clinical trial study, 200 patients with anal fissures were randomly divided into two groups. The intervention group was treated with diltiazem gel, psyllium powder, lactulose syrup, and hydrocortisone topical ointment. Hydrocortisone ointment was not used in the control group.
Results: The mean scores of initial pain were 8.06±0.7 and 7.79±1.02 in the intervention and control groups, respectively. The mean pain at the end of the first week was 2.5±1.06 in the intervention group and 3.34±0.89 in the control group. Pain reduction was significantly higher in the intervention group than in the control group in the first week of treatment. Two weeks later, the pain was 1.46±0.7 in the intervention group and 1.86±0.74 in the control group. There was a significant difference between the two groups in the first and second weeks of treatment.
Conclusion: The therapeutic combination of a topical corticosteroid with a calcium channel blocker at the beginning of treatment for chronic fissures during the first week of treatment led to a faster response in the form of pain reduction
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Type of Study: Original | Subject: General Surgery

1. Sandborn WJ, Lee SD, Randall C, Gutierrez A, Schwartz DA, et al. Long‐term safety and efficacy of certolizumab pegol in the treatment of Crohn's disease: 7‐year results from the PRECiSE 3 study. Aliment Pharmacol Ther. 2014;40(8):903-16. PMID: 25146586 DOI: 10.1111/apt.12930
2. Zaghiyan KN, Fleshner P. Anal fissure. Clin Colon Rectal Surg. 2011;24(1):22-31. PMID: 22379402 DOI: 10.1055/s-0031-1272820
3. Nelson RL, Chattopadhyay A, Brooks W, Platt I, Paavana T, Earl S. Operative procedures for fissure in ano. Cochrane Database of Syst Rev. 2010:12(1).10-18. PMID: 22071803 DOI: 10.1002/14651858.CD002199.pub4
4. Medhi B, Rao RS, Prakash A, Prakash O, Kaman L, Pandhi P. Recent advances in the pharmacotherapy of chronic anal fissure: an update. Asian J Surg. 2008;31(3):154-6. PMID: 18658016 DOI: 10.1016/S1015-9584(08)60078-0
5. Perrotti P, Dominici P, Grossi E, Cerutti R, Antropoli C. Topical nifedipine with lidocaine ointment versus active control for pain after hemorrhoidectomy: results of a multicentre, prospective, randomized, double-blind study. Can J Surg. 2010;53(1):17-24. PMID: 20100408
6. Jensen SL, Lund F, Nielsen OV, Tange G. Treating fissure in ano in outpatients: what dose of local anaesthetic. Br Med J. 1984;289(6451):1079.
7. Toksini AF, Sonrası U. Duration of the sypmtoms influence the outcome after botulinum toxin injection in anal fissure. Turk J Colorectal Dis.2019;29:33-8.
9. Maihara T, Iwamuro F, Tanabe H, Taguchi T, Hata R. Subaru deep survey I. near-infrared observations. Publ Astr Soc Japan. 2001;53(1):25-36. DOI: 10.1093/pasj/53.1.25
10. Catenacci DV, Kang YK, Park H, Uronis HE, Lee KW, Ng MC, et al. Margetuximab plus pembrolizumab in patients with previously treated, HER2-positive gastro-oesophageal adenocarcinoma (CP-MGAH22–05): a single-arm, phase 1b–2 trial. Lancet Oncol. 2020;21(8):1066-76. PMID: 32653053 DOI: 10.1016/S1470-2045(20)30326-0
11. Mapel DW, Schum M, Von Worley A. The epidemiology and treatment of anal fissures in a population-based cohort. BMC Gastroenterol. 2014;14:1-7. DOI: 10.1186/1471-230X-14-129
12. Gagliardi G, Pascariello A, Altomare DF. Optimal treatment duration of glyceryl trinitrate for chronic anal fissure: results of a prospective randomized multicenter trial. Tech Coloproctol. 2010;14:241–8. PMID: 20632059 DOI: 10.1007/s10151-010-0604-1
13. Perrotti P, Bove A, Antropoli C, Molino D, Antropoli M, Balzano A, et al. Topical nifedipine with lidocaine ointment vs. active control for treatment of chronic anal fissure: results of a prospective, randomized, double-blind study. Dis Colon Rectum. 2002;45:1468–75. PMID: 12432293 DOI: 10.1007/s10350-004-6452-1
14. Ezri T, Susmallian S. Topical nifedipine vs topical glyceryl trinitrate for treatment of chronic anal fissure. Dis Col Rectum. 2003;46:805–8. PMID: 12794583 DOI: 10.1007/s10350-004-6660-8

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