Diltiazem Ointment
Formulation: Diltiazem 2%
Ointment for treating anal fissures.
Description
Diltiazem dilates blood vessels to help improve anal fissures. The medication works to relax smooth muscle of the internal anal sphincter. This allows the tear in the anus to heal as blood flow improves. An anal fissure is a tear in the anal canal that frequently is related to spasms and tension of the internal anal sphincter. The anal sphincter is a group of muscles located at the end of the rectum. The internal anal sphincter provides much of the resting pressure of the anal canal which is important for bowel continence.
The use of a topical diltiazem ointment can greatly improve the healing time for an anal fissure and possibly prevent the fissure from becoming chronic. The ointment may also be used to treat external hemorrhoids. Topical treatment has been shown in studies to be the most effective way to treat fissures.
What is Diltiazem?
Diltiazem is a calcium channel blocker typically used to treat high blood pressure and angina. When used to treat heart conditions it is taken orally. For treating anal fissures it is usually applied in a topical cream. In a study of 106 gastroenterologists in the Netherlands, 90% chose diltiazem as the preferred ointment for treating anal fissures.
In a study that compared calcium channel blockers with other treatments for chronic anal fissures, ointments like diltiazem were more effective. Other interventions like botulinum toxin injections were not shown to be superior to topical treatments.
Side effects from diltiazem ointment are not common but may include dizziness, headache, weakness, and nausea. If any of these symptoms present as being severe they should be reported to the patient’s doctor.
Articles
The role of topical diltiazem in the treatment of chronic anal fissures that have failed glyceryl trinitrate therapy – Colorectal Disease
Management of chronic anal fissure: results of a national survey among gastrointestinal surgeons in the Netherlands – International Journal of Colorectal Disease
Clinical outcomes of Medical management options for chronic anal fissures in a long term follow up: systematic review and meta-analysis – Digestive Diseases
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