title: Quality of life in patients with chronic anal fissure after topical treatment with diltiazem.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  Successful treatment of chronic anal fissure with topical diltiazem leads to improvement in health-related quality of life.
authors.affiliation: Akira Tsunoda, Nobuyasu Kano, Department of Surgery, Kameda Medical Center, Chiba 296-8602, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsunoda
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Kashiwagura
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Hirose
authors.forename: Tadanori
authors.initials: T
authors.lastname: Sasaki
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Kano
keywords: Anal fissure; Diltiazem; Quality of life