title: Oral nifedipine in the treatment of chronic anal fissure.
abstract: BACKGROUND
  The purpose of this study was to demonstrate the effect of oral nifedipine on maximal resting anal pressure (MRAP) in healthy volunteers and to evaluate its role in the treatment of chronic anal fissure (CAF).
  
  
  METHODS
  MRAP was measured in 10 healthy volunteers and 10 patients with CAF before and after oral nifedipine (20 mg b.i.d.). Patients were assessed on the first visit and every fortnight for measurement of MRAP, pain scores, blood pressure, pulse rate, healing of the fissure and adverse effects. Treatments were continued until healing had occurred or for up to 8 weeks.
  
  
  RESULTS
  MRAP values before and after nifedipine were 73.2 and 49.3 cm H2O, respectively, in healthy volunteers (p < 0.001). Nifedipine caused a reduction in mean MRAP from 105.2 to 74.0 cm H2O (p < 0.001) in patients with CAF. Pain scores were significantly reduced after 2 weeks of treatment with nifedipine (p < 0.001) and continued throughout the treatment period. At the end of the study 6 of the 10 patients treated with nifedipine were deemed to be healed (n = 5) or improved (n = 1). Headache occurred in 1 patient.
  
  
  CONCLUSIONS
  We conclude that oral nifedipine is effective in reducing MRAP and should become the first-line treatment for CAF.
authors.affiliation: Karadeniz Technical University, Faculty of Medicine, Department of General Surgery, Trabzon, Turkey. nagaoglu@meds.ktu.edu.tr
authors.forename: Nazim
authors.initials: N
authors.lastname: Ağaoğlu
authors.forename: Salahattin
authors.initials: S
authors.lastname: Cengiz
authors.forename: Mithat Kerim
authors.initials: MK
authors.lastname: Arslan
authors.forename: Serdar
authors.initials: S
authors.lastname: Türkyilmaz
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D002908:Chronic Disease; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D010147:Pain Measurement; D011312:Pressure; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D002121:Calcium Channel Blockers; D009543:Nifedipine