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Treatment of first episodes of acute anal fissure: prospective randomised study of lignocaine ointment versus hydrocortisone ointment or warm sitz baths plus bran.

Abstract
One hundred and three patients with an acute first episode of posterior anal fissure were randomised to receive a three week trial of lignocaine ointment (n = 33) versus hydrocortisone ointment (n = 35) or warm sitz baths combined with an intake of unprocessed bran (n =35). Seven patients were withdrawn owing to failure to adhere to the trial protocol. After one and two weeks of treatment symptomatic relief was significantly better among patients treated with sitz baths and bran than among patients treated with lignocaine ointment or hydrocortisone ointment. After three weeks there was no difference in symptomatic relief among the three groups. Patients treated with lignocaine, however, had significantly fewer healed fissures (60%) than patients treated with hydrocortisone (82.4%) or warm sitz baths and bran (87%). In this study warm sitz baths plus an intake of unprocessed bran came out as the treatment of choice for an acute first episode of posterior anal fissure. This treatment is cheap, has no potential serious side effects, and brings the best and quickest relief of symptoms.
AuthorsS L Jensen
JournalBritish medical journal (Clinical research ed.) (Br Med J (Clin Res Ed)) Vol. 292 Issue 6529 Pg. 1167-9 (May 03 1986) ISSN: 0267-0623 [Print] England
PMID3011180 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Dietary Fiber
  • Ointments
  • Lidocaine
  • Hydrocortisone
Topics
  • Acute Disease
  • Adult
  • Baths
  • Clinical Trials as Topic
  • Dietary Fiber (therapeutic use)
  • Female
  • Fissure in Ano (drug therapy, therapy)
  • Humans
  • Hydrocortisone (administration & dosage, therapeutic use)
  • Lidocaine (administration & dosage, therapeutic use)
  • Male
  • Middle Aged
  • Ointments
  • Prospective Studies
  • Random Allocation

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