Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Surg. Nov 27, 2012; 4(11): 251-255
Published online Nov 27, 2012. doi: 10.4240/wjgs.v4.i11.251
Quality of life in patients with chronic anal fissure after topical treatment with diltiazem
Akira Tsunoda, Yasuharu Kashiwagura, Ken-ichi Hirose, Tadanori Sasaki, Nobuyasu Kano
Akira Tsunoda, Nobuyasu Kano, Department of Surgery, Kameda Medical Center, Chiba 296-8602, Japan
Yasuharu Kashiwagura, Ken-ichi Hirose, Tadanori Sasaki, Department of Pharmacy Services, Kameda Medical Center, Chiba 296-8602, Japan
Author contributions: All authors contributed equally to this work.
Supported by The Department of Pharmacy Services, Kameda Medical Center Foundation
Correspondence to: Akira Tsunoda, MD, PhD, Chief, Department of Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa City, Chiba 296-8602, Japan. a.tsunoda@kameda.jp
Telephone: +81-4-70922211 Fax: +81-4-70991198
Received: April 4, 2012
Revised: August 27, 2012
Accepted: November 1, 2012
Published online: November 27, 2012
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; Quality of life; Diltiazem