PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Increasing efficacy and reducing side effects in treatment of chronic anal fissures: A study of topical diazepam therapy.

Abstract This is a single institution nonexperimental study intended to analyze the therapeutic efficacy of topical diazepam in treating symptoms of chronic anal fissures.Anal fissures are a common cause of anal pain. Conventional treatments include nonsteroidal anti-inflammatory drugs, topical creams, such as nitroglycerin and nifedipine, and surgery. However, these treatments are usually suboptimally efficacious or have deterring side effects.Patients at an outpatient community center with a diagnosis of a chronic anal fissure were prescribed either topical 2% (n = 19) or 4% (n = 18) diazepam cream between January 2013 and February 2015. We retrospectively analyzed their responses to treatment.All 19 patients using 2% diazepam cream experienced a positive response in pain, whereas 47.4% experienced a complete response, with a numerical rating scale (NRS) score of 0 (0-10). Eighty-eight percent of patients using 4% dose had a positive response in pain, whereas 23.5% experienced a complete response. Ninety-four percent of patients using 2% dose had a positive response in anal bleeding, whereas 68.8% experienced a complete response with an anal bleeding score (ABS) of 2 (2-9). Ninety-four percent of patients using 4% dose had a positive response in anal bleeding, whereas 64.7% experienced a complete response. Only 1 patient reported a side effect from diazepam cream-perianal pruritus.Both 2% and 4% topical diazepam provided significant pain and bleeding relief from chronic anal fissures that were refractory to conventional therapies. There were insignificant differences when assessing independent comparisons for pain and bleeding between the doses.
PMID
Related Publications

Treatment of chronic anal fissure with topical glyceryl trinitrate.

Diltiazem heals glyceryl trinitrate-resistant chronic anal fissures: a prospective study.

Glyceryl trinitrate ointment for the treatment of chronic anal fissure: results of a placebo-controlled trial and long-term follow-up.

Local nitroglycerin for treatment of anal fissures: an alternative to lateral sphincterotomy?

A randomized trial of oral vs. topical diltiazem for chronic anal fissures.

Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28514300
OWN - NLM
STAT- MEDLINE
DA  - 20170517
DCOM- 20170613
LR  - 20170613
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 20
DP  - 2017 May
TI  - Increasing efficacy and reducing side effects in treatment of chronic anal
      fissures: A study of topical diazepam therapy.
PG  - e6853
LID - 10.1097/MD.0000000000006853 [doi]
AB  - This is a single institution nonexperimental study intended to analyze the
      therapeutic efficacy of topical diazepam in treating symptoms of chronic anal
      fissures.Anal fissures are a common cause of anal pain. Conventional treatments
      include nonsteroidal anti-inflammatory drugs, topical creams, such as
      nitroglycerin and nifedipine, and surgery. However, these treatments are usually 
      suboptimally efficacious or have deterring side effects.Patients at an outpatient
      community center with a diagnosis of a chronic anal fissure were prescribed
      either topical 2% (n = 19) or 4% (n = 18) diazepam cream between January 2013 and
      February 2015. We retrospectively analyzed their responses to treatment.All 19
      patients using 2% diazepam cream experienced a positive response in pain, whereas
      47.4% experienced a complete response, with a numerical rating scale (NRS) score 
      of 0 (0-10). Eighty-eight percent of patients using 4% dose had a positive
      response in pain, whereas 23.5% experienced a complete response. Ninety-four
      percent of patients using 2% dose had a positive response in anal bleeding,
      whereas 68.8% experienced a complete response with an anal bleeding score (ABS)
      of 2 (2-9). Ninety-four percent of patients using 4% dose had a positive response
      in anal bleeding, whereas 64.7% experienced a complete response. Only 1 patient
      reported a side effect from diazepam cream-perianal pruritus.Both 2% and 4%
      topical diazepam provided significant pain and bleeding relief from chronic anal 
      fissures that were refractory to conventional therapies. There were insignificant
      differences when assessing independent comparisons for pain and bleeding between 
      the doses.
FAU - Hang, Minh Tuan H
AU  - Hang MTH
AD  - aDivision of Gastroenterology, Department of Internal Medicine, Mercer University
      School of Medicine, Macon, GA bDivision of Medicine, Medical University of South 
      Carolina, Charleston, SC cDivision of Digestive Diseases, Rush University Medical
      Center, Chicago, IL.
FAU - Smith, Betsy E
AU  - Smith BE
FAU - Keck, Carson
AU  - Keck C
FAU - Keshavarzian, Ali
AU  - Keshavarzian A
FAU - Sedghi, Shahriar
AU  - Sedghi S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Analgesics)
RN  - Q3JTX2Q7TU (Diazepam)
SB  - AIM
SB  - IM
MH  - Administration, Topical
MH  - Analgesics/*administration & dosage/adverse effects
MH  - Chronic Disease
MH  - Diazepam/*administration & dosage/adverse effects
MH  - Dose-Response Relationship, Drug
MH  - Drug Resistance
MH  - Female
MH  - Fissure in Ano/*drug therapy/physiopathology
MH  - Follow-Up Studies
MH  - Hemorrhage/drug therapy/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outpatients
MH  - Pain/drug therapy/physiopathology
MH  - Pain Measurement
MH  - Quality Improvement
MH  - Retrospective Studies
PMC - PMC5440137
EDAT- 2017/05/18 06:00
MHDA- 2017/06/14 06:00
CRDT- 2017/05/18 06:00
AID - 10.1097/MD.0000000000006853 [doi]
AID - 00005792-201705190-00017 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 May;96(20):e6853. doi: 10.1097/MD.0000000000006853.

<?xml version="1.0" encoding="UTF-8"?>
<b:Sources SelectedStyle="" xmlns:b="http://schemas.openxmlformats.org/officeDocument/2006/bibliography"  xmlns="http://schemas.openxmlformats.org/officeDocument/2006/bibliography" >
</b:Sources>