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Clinical question
How effective are topical treatments (calcium channel blockers [CCBs], nitrates, and vitamin E) for
chronic anal fissures in adults?
Bottom line
Healing rates with topical nitroglycerin are roughly
60% versus 40% with placebo at 8 weeks. Topical
CCBs are at least as good as nitroglycerin, with a
lower risk of headache (7% versus 56%). Based on
1 RCT, topical vitamin E may be superior to nitroglycerin (86% versus 66% healed at 8 weeks).
