AIMS OF THE STUDY:
1) To find the age and the sex incidence of fissure in ano.
2) To study the various modes of clinical presentation of fissure in ano and the various types of fissure in ano.
3) To evaluate the effectiveness of topical 0.2% Glyceryl trinitrate in the symptomatic relief and healing of anal fissures.
4) To compare the effectiveness of lateral anal sphincterotomy and chemical
sphincterotomy in fissure in ano.
5) To establish the role of glyceryl trinitrate as the first line treatment for
both acte and chronic fissures.
MATERIALS AND METHODS:
SETTING:
Study was a prospective comparative study done in Government Kilpauk
Medical College Hospital from January 2015 to June 2015. The Study Population
was divided into two groups.The Patients were of age group 18 to 60 years. 100
cases were studied.
STUDY POPULATION:
The study population was divided into two groups of 50 patients each.
One study group was treated with topical application of 0.2% Glyceryl trinitrate
along with sitz bath.
Oral antibiotics such as Cap Amoxycillin 500 mg BD and Tab. Metronidazole
400 mg TDS for the first 1 week along with topical 0.2% Glyceryl trinitrate
application about the size of a pea, over the anal verge thrice daily for a period of 4
weeks and observed.
Another study group was admitted in the ward and taken up for lateral anal
sphincterotomy under antibiotic over and a preoperative plain water enema.
The results were analyzed and published.
RESULT:
In the end of the study we found that the surgical procedure for fissure in ano
has better cure rate than medical management.
CONCLUSION:
The fissure in ano has a slight female preponderance.The sex incidence ratio
is 1.2:1 in favour of females.
• The fissure is ano occurs more commonly in 3rd decade (ie) young adults.
• The most common clinical presentation of fissure in ano is painful
defecation,which occurs is 90 out of 100 patients studied.
• The incidence of both acute and chronic fissures were almost the same.
• The most common location of fissure is posterior midline.86 out of 100
patients showed fissure in the posterior midline .Only 14 patients had
anterior midline fissure . Of these all were females.
• Surgery in the form of open or closed lateral anal sphincterotomy forms the
definitive treatment , healing fissure in almost all patients with very few
postoperative complications.
• Chemical sphincterotomy (ie) topical application of 0.2%
Glyceryltrinitrate healed 33 out of 50 patients (i.e) 64% efficacy rate.
• The most promment side effect of topical application of 0.2%
Glyceryltrinitrate, (ie) headache was present in 24% and was tolerable and
relieved by simple analgesics.
• Hence topical application of 0.2% Glyceryltrinitrate can be established as
the first line treatment of acute and chronic and fissures
