HEALING WITHOUT KNIFE: NON SURGICAL APPROACH FOR CHRONIC ANAL FISSURE
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Keywords
Anal fissure, glyceryl trinitrate, bleeding
Abstract
OBJECTIVE: To assess the effectiveness of 0.2% glyceryl trinitrate ointment in the management of chronic anal fissure.
PATIENTS AND METHODS: A prospective study was carried out by the surgical outpatient department of MMC general hospital, peshawar from january 2023 to july 2023. Fifty consecutive patients were treated with 0.2% glyceryl trinitrate ointment and reviewed at 3 , 6 , and 12 weeks interval. Data was analysed by SPSS version 22. Mean and SD was applied for quantitative data Frequency and percentage was applied for qualitative data.
RESULT: At six weeks fissure healed in 70% of the patients. There was a remarkable improvement in the symptoms of pain, bleeding and irritation.30% of the patients had no improvement. At 3 months interval there was no recurrence with 70% healing rate.
Patients whose fissure were healed reported an improvement in bodily pain , health perception , vitality and mental health.
CONCLUSION: GTN is a useful first-line non-surgical treatment for chronic anal fissures, particularly for pain relief and promoting initial healing. However, its effectiveness may be limited by side effects and recurrence rates, so it is often considered part of a comprehensive treatment plan.
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Azhar Zahir Shah
Professor General Surgery, Department of Surgery, Sardar Begum Dental College, Peshawar, Pakistan
Ahmad Zeb
Department of Surgery, Kabir Medical College, Peshawar, Pakistan
Aurang zeb
Department of Anaesthesia, Kabir Medical College, Peshawar, Pakistan
Adil shah roghani
Department of Surgery, Kabir Medical College, Peshawar, Pakistan
Jibran Umar Ayub Khan
Department of Medicine, Kabir Medical College, Peshawar, Pakistan
Ayesha Qaiser
Department of Physiology, Khyber Medical College, Peshawar, Pakistan