title: Long-term follow-up of chronic anal fissure (CAF) on diltiazem 2% using a telephone questionnaire. Do results change?
abstract: BACKGROUND
  Calcium channel blockers have an excellent effectiveness in the conservative management of chronic anal fissure (CAF).
  
  
  OBJECTIVE
  To assess the long-term results of management with diltiazem 2% ointment using a telephone questionnaire.
  
  
  METHODS
  A descriptive, retrospective study from March 2004 to March 2011 in patients with CAF on diltiazem 2%, 3 applications daily for 4-6 weeks. Starting at 12 months a questionnaire was administered over the phone by medical staff outside the surgery department to record socio-demographic data, predominant manifestations, and response to diltiazem on a 5-point scale measuring symptom relief (1 = poorest, 5 = best). Patients with therapy failure were referred to surgery.
  
  
  RESULTS
  The study was completed for 166 patients with a mean age of 54.1 years. CAF was posterior in 82.3% of subjects. Diltiazem tolerability was excellent with only 4 adverse event cases (3 skin irritation, 1 hypotension). We obtained symptom relief in 62.1% of patients and CAF healing in 51.2%, and referred 33.7% to surgery. The questionnaire showed that 74.1% of patients had used only 2 applications daily, and that results were better with an increased number of applications, albeit without statistical significance.
  
  
  CONCLUSIONS
  The telephone questionnaire showed symptom relief for 62% and healing for 51.2% of patients with CAF on diltiazem 2%, which should be considered first-choice for the conservative management of this condition.
authors.forename: Enrique
authors.initials: E
authors.lastname: Canelles
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Bernal
authors.forename: Juan
authors.initials: J
authors.lastname: Berasategui
authors.forename: José
authors.initials: J
authors.lastname: Puche
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Landete
authors.forename: Leonardo
authors.initials: L
authors.lastname: de-Tursi
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002908:Chronic Disease; D004110:Diltiazem / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013689:Telephone; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002121:Calcium Channel Blockers; D004110:Diltiazem