{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:21:04Z","timestamp":1789669264384,"version":"4.0.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2001,4,1]],"date-time":"2001-04-01T00:00:00Z","timestamp":986083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic anal fissure has traditionally been treated surgically. Initial enthusiasm for chemical sphincterotomy has waned because of poor outcomes with glyceryl trinitrate ointment. In this study the use of topical 2 per cent diltiazem ointment has been investigated as an alternative method of chemical sphincterotomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective assessment of 71 consecutive patients with a chronic anal fissure treated with 2 per cent topical diltiazem ointment for a median duration of 9 (range 2\u201316) weeks was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-one patients (75 per cent) experienced healing of the fissure after 2\u20133 months of treatment with topical diltiazem. Seventeen patients who did not heal were treated for a further 8 weeks with topical diltiazem. Eight of these patients subsequently healed with diltiazem. Fifty-nine of 67 patients who completed follow-up therefore healed on diltiazem ointment. Four patients experienced perianal dermatitis and one patient experienced headaches. No other side-effects were recorded. After a median of 32 (range 14\u201367) weeks' follow-up following completion of treatment, 27 of 41 patients available remain symptom free. Six of seven patients with recurrent fissure were treated successfully by repeat chemical sphincterotomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Topical 2 per cent diltiazem ointment used as an agent for chemical sphincterotomy for chronic anal fissure offers significant healing rates but does not have a significant side-effect profile, which may aid compliance to treatment. Early recurrences are common but usually amenable to further chemical sphincterotomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1046\/j.1365-2168.2001.01736.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T07:22:30Z","timestamp":1047367350000},"page":"553-556","source":"Crossref","is-referenced-by-count":110,"title":["Topical diltiazem ointment in the treatment of chronic anal fissure"],"prefix":"10.1093","volume":"88","author":[{"given":"J S","family":"Knight","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Royal Berkshire and Battle Hospitals , Oxford Road, Reading RG30 1AG,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Birks","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Royal Berkshire and Battle Hospitals , Oxford Road, Reading RG30 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