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Research Paper | Surgery | Volume 15 Issue 3, March 2026 | Pages: 1668 - 1670 | India
A Comparative Study Between 0.3% Topical Nifedipine Ointment and Lateral Internal Sphincterotomy in the Treatment of Chronic Anal Fissure at a Tertiary Care Centre
Abstract: Background: Chronic anal fissure is a frequently encountered and painful anorectal condition characterized by a tear in the anoderm distal to the dentate line.1 The condition is perpetuated by a cycle of pain, internal anal sphincter spasm, and reduced blood flow to the affected region. Management aims to interrupt this cycle through either pharmacological or surgical reduction of sphincter tone. While lateral internal sphincterotomy remains the gold standard surgical treatment, topical calcium channel blockers such as nifedipine have emerged as effective conservative alternatives.2 Objectives: To evaluate and compare the effectiveness of topical 0.3% nifedipine ointment with lateral internal sphincterotomy in patients with chronic anal fissure and to assess the complications associated with both treatment modalities. Methods: A comparative cross-sectional study was conducted at the Department of General Surgery, Akash Institute of Medical Sciences and Research Centre, Bengaluru, from March 2024 to September 2025. A total of 94 patients aged between 18 and 60 years diagnosed with chronic anal fissure were included. Participants were divided into two groups: Group I (47 patients) received topical 0.3% nifedipine ointment for six weeks, while Group II (47 patients) underwent lateral internal sphincterotomy. Patients were followed at 2, 4, and 6 weeks to assess healing and symptom relief. Statistical analysis was performed using SPSS software, and a p-value <0.05 was considered statistically significant. Results: Both treatment groups demonstrated progressive healing over the follow-up period. However, patients treated with lateral internal sphincterotomy showed significantly higher healing rates at all follow-up intervals compared to the nifedipine group (p < 0.05). The mean healing rate at 6 weeks was 93.4% in the nifedipine group and 96.0% in the sphincterotomy group. Topical nifedipine therapy was associated with minimal adverse effects including headache (8.5%), flushing (2.1%), and perianal dermatitis (4.3%). In contrast, the surgical group experienced complications such as anal irritation (6.4%) and flatus incontinence (10.6%). Conclusion: Lateral internal sphincterotomy provides faster and more complete healing in chronic anal fissure compared with topical nifedipine therapy. However, topical nifedipine remains an effective and well-tolerated non-surgical alternative with fewer complications. Treatment selection should therefore be individualized based on patient preference, clinical presentation, and potential risk of postoperative complications.
Keywords: Chronic anal fissure, topical nifedipine, lateral internal sphincterotomy, chemical sphincterotomy, anal fissure management
How to Cite?: Dr. R Varun Gowda, Dr. Ganesh Babu K M, Dr. Chandramouli N, "A Comparative Study Between 0.3% Topical Nifedipine Ointment and Lateral Internal Sphincterotomy in the Treatment of Chronic Anal Fissure at a Tertiary Care Centre", Volume 15 Issue 3, March 2026, International Journal of Science and Research (IJSR), Pages: 1668-1670, https://www.ijsr.net/getabstract.php?paperid=SR26326195522, DOI: https://dx.dx.doi.org/10.21275/SR26326195522