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World J Gastrointest Surg. 2012 Nov 27;4(11):251-5. doi: 10.4240/wjgs.v4.i11.251.

Quality of life in patients with chronic anal fissure after topical treatment with diltiazem.

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1
Akira Tsunoda, Nobuyasu Kano, Department of Surgery, Kameda Medical Center, Chiba 296-8602, Japan.

Abstract

AIM:

To assess the physical and mental health of fissure patients before and after topical treatment with diltiazem.

METHODS:

Consecutive patients were enrolled prospectively into the study. Quality of life was measured with the short-forum 36 health survey (SF-36) before and after 6-wk treatment with diltiazem. Patients scored symptoms of pain, bleeding, and irritation using numeral rating scales at the initial and follow-up visits. Fissure healing was assessed and side effects were noted.

RESULTS:

Fissures healed in 21 of 30 (70%) patients. There were significant reductions in the scores of pain, bleeding, and irritation after 1 wk of treatment, respectively. Four patients experienced perianal itching and one patient reported headache. When measured at baseline, pain and irritation showed a negative impact on two of the eight subscales on the SF-36, respectively (bodily pain and social functioning for pain; vitality and mental health for irritation). Repeating the SF-36 showed an improvement in bodily pain (P = 0.001). Patients whose fissures healed reported an improvement in bodily pain, health-perception, vitality, and mental health (P < 0.05).

CONCLUSION:

Successful treatment of chronic anal fissure with topical diltiazem leads to improvement in health-related quality of life.

KEYWORDS:

Anal fissure; Diltiazem; Quality of life

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