Maximal resting anal pressure (MRAP) is thought to be high in patients with chronic anal fissure.
Treatment of chronic anal fissure aims to reduce MRAP to allow increased blood flow to the injured area, allowing the fissure to heal.
Doctors in Turkey examined the effect of oral nifedipine on MRAP in healthy volunteers and the effect of the drug on MRAP and healing in patients with chronic anal fissure.
20 mg of oral nifedipine was administered twice daily and MRAP was measured every 2 weeks throughout treatment.
The MRAP in10 healthy volunteers fell from an average of 73.2 cm H2O before nifedipine treatment to 49.3 cm H2O after treatment.
Nifedipine caused a reduction in mean MRAP from 105.2 to 74.0 cm H2O in patients with chronic anal fissure.
Pain scores in patients with chronic anal fissure were significantly reduced after 2 weeks of treatment with nifedipine.
| Oral nifedpine should become the first-line treatment for chronic anal fissure.|
5 out of 10 patients with chronic anal fissure were healed by nifedipine treatment and a further patient saw a significant improvement in the course of the condition.
The authors of the study conclude that. “Oral nifedipine is effective in reducing MRAP and should become the first-line treatment for chronic anal fissure.”