ArticleWorld journal of gastrointestinal pharmacology and therapeutics2011
Identifying the best therapy for chronic anal fissure.
Article in World journal of gastrointestinal pharmacology and therapeutics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 68 citations in OpenAlex.
- Topical Minoxidil Versus Topical Diltiazem for Chemical Sphincterotomy of Chronic Anal Fissure: A Prospective, Randomized, Double-Blind, Clinical Trial.World journal of surgery · 2018Trial
- Maintenance therapy with partially hydrolyzed guar gum in the conservative treatment of chronic anal fissure: results of a prospective, randomized study.BioMed research international · 2014Trial
- Transcutaneous electrical posterior tibial nerve stimulation for chronic anal fissure: a preliminary study.International journal of colorectal disease · 2013Trial
- A prospective, randomized, double-blind study comparing the efficacy of diltiazem, glyceryl trinitrate, and lidocaine for the treatment of anal fissure in children.Pediatric surgery international · 2012Trial
- Combined Tribenoside/Lidocaine Rectal Cream (Procto-GlyvenolPharmaceuticals (Basel, Switzerland) · 2026Article
- Treatment of chronic anal fissure in Crohn's disease patients with freshly collected autologous adipose tissue: a pilot study.Techniques in coloproctology · 2025Article
- The Effect of Sphincter Pressure and Anal Length on Surgical Decision in Chronic Anal Fissure.Journal of clinical medicine · 2025Article
- Depression in patients with anorectal fistulas and anal fissures: a propensity score-matched cohort study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Comparative Analysis of Open and Closed Sphincterotomy for the Treatment of Chronic Anal Fissure: Safety and Efficacy Evaluation.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- The Assessment of Marcaine Versus Meperidine for Spinal Anesthesia in Anorectal Surgery: A Randomized Clinical Trial.Anesthesiology and pain medicine · 2023Article
- Endoscopic Ultrasound-Guided Botox Injection for Refractory Anal Fissure.Journal of clinical medicine · 2022Article
- Safety and effectiveness of minimal sphincterotomy in the treatment of female patients with chronic anal fissure.Updates in surgery · 2021Article
- Minimal Lateral Internal Sphincterotomy (LIS): Is It Enough to Cut Less Than the Conventional Tailored LIS?Annals of coloproctology · 2021Article
- Recovery from hemorrhoids and anal fissure without surgery.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2020Article
- The association between body mass index and anal canal human papillomavirus prevalence and persistence: the HIM study.Human vaccines & immunotherapeutics · 2019Article
- Lateral Anal Sphincterotomy for Chronic Anal Fissures- A Comparison of Outcomes and Complications under Local Anaesthesia Versus Spinal Anaesthesia.Journal of clinical and diagnostic research : JCDR · 2017Article
- Time Trends, Clinical Characteristics, and Risk Factors of Chronic Anal Fissure Among a National Cohort of Patients with Inflammatory Bowel Disease.Digestive diseases and sciences · 2016Article
- Anal fissure.Australian prescriber · 2016Review
- Myoxinol (Hydrolyzed Hibiscus esculentus Extract) in the Cure of Chronic Anal Fissure: Early Clinical and Functional Outcomes.Gastroenterology research and practice · 2015Article
- The epidemiology and treatment of anal fissures in a population-based cohort.BMC gastroenterology · 2014Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic anal fissure (CAF) is a painful tear or crack which occurs in the anoderm. The optimal algorithm of therapy for CAF is still debated. Lateral internal sphincterotomy (LIS) is a surgical treatment, considered as the 'gold standard' therapy for CAF. It relieves CAF symptoms with a high rate of healing. Chemical sphincterotomy (CS) with nitrates, calcium blockers or botulinum toxin (BTX) is safe, with the rapid relief of pain, mild side-effects and no risk of surgery or anesthesia, but is a statistically less effective therapy for CAF than LIS. This article considers if aggressive treatment should only be offered to patients who fail pharmacological sphincterotomy. Aspects of anal fissure etiology, epidemiology and pathophysiology are considered with their meaning for further management of CAF. A molecular model of chemical interdependence significant for the chemistry of CAF healing is examined. Its application may influence the development of optimal therapy for CAF. BTX is currently considered the most effective type of CS and discussion in this article scrutinizes this method specifically. Although the effectiveness of BTX vs. LIS has been discussed, the essential focus of the article concerns identifying the best therapy application for anal fissure. Elements are presented which may help us to predict CAF healing. They provide rationale for the expansion of the CAF therapy algorithm. Ethical and economic factors are also considered in brief. As long as the patient is willing to accept the potential risk of fecal incontinence, we have grounds for the 'gold standard' (LIS) as the first-line treatment for CAF. The author concludes that, when the diagnosis of the anal fissure is established, CS should be considered for both ethical and economic reasons. He is convinced that a greater understanding and recognition of benign anal disorders by the GP and a proactive involvement at the point of initial diagnosis would facilitate the consideration of CS at an earlier, more practical stage with improved outcomes for the patient.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.