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

Abstract

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.

Keywords: Anal fissure; Diltiazem; Quality of life.

Figures

Figure 1

Median short-forum 36 health survey scores before and after treatment. SF-36: Short-Forum 36 Health Survey. aP = 0.001, before treatment vs after treatment.

Figure 2

Median short-forum 36 health survey scores in healed group before and after treatment. SF-36: Short-Forum 36 Health Survey. aP = 0.009, bP = 0.03, cP = 0.02, dP = 0.04.