Treatment Of Chronic Anal Fissure

Launched by BISPEBJERG HOSPITAL · Jun 5, 2014

Keywords

ClinConnect Summary

Anal fissure is an ulcer-like, longitudinal tear in the anal canal, most commonly located in the dorsal or ventral midline, and distal to the dentate line. Anal fissures constitute a common medical problem that affects sexes equally. The initiation of the fissure is most likely caused by the passage of hard stools that traumatizes the anal canal. Patients suffer from anal pain lasting up to several hours after defecation and rectal bleeding.3 Most acute anal fissures heal spontaneously, but a proportion progress into chronic fissures with symptoms beyond 8-12 weeks. There is no strict defin...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Danish citizens, age ≥ 18 years
• • 2. Presence of a midline anal fissure, dorsal or ventral
• • 3. Pain during and after defecation lasting for more than 8 weeks
• • 4. Presence of a sentinel anal tag or hypertrophic papilla
• • 5. Exposure of the horizontal fibres of the internal anal sphincter
• • 1-3 has to be fulfilled for inclusion. Additionally 4 AND/OR 5 has to be present
• Exclusion Criteria:
• • 1. Inflammatory bowel disease, known venereal disease, immunodeficiency disease
• • 2. Anal/perianal abscess
• • 3. Anal or rectal surgery within 12 weeks
• • 4. Pregnancy or breastfeeding females
• • 5. History of migraine or chronic headache requiring treatment with analgetics
• • 6. Any cardiovascular or cerebrovascular disease
• • 7. Current use of calcium channel blockers in general or history of use of calcium channel blockers in the treatment of the fissure
• • 8. Signs of other rectal diseases, fistula, infection including severe perianal eczema and tumours