Quality of life in patients with chronic anal fissure after topical treatment with diltiazem

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.