Journals / Turkish Journal of Clinics and Laboratory / 2026 / Cilt: 16 Sayı: 3

Enhanced healing and pain relief in anal fissure treatment: evaluating the role of triticum vulgare in conjunction with diltiazem cream

Anal fissür tedavisinde artırılmış iyileşme ve ağrı giderme: diltiazem krem ile birlikte triticum vulgarenin rolünün değerlendirilmesi

Serhat Ocaklı(ANKARA MEDİPOL ÜNİVERSİTESİ)0000-0002-3176-4914
İbrahim Doğan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, VAN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0001-7413-1837
Sabiha Nur Özmen(Sabuncuoğlu Şerefeddi Eğitim ve Araştırma Hastanesi)0000-0002-4669-0962
Cengiz Ceylan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ESKİŞEHİR ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0000-0003-3471-8726
Pages
540–544
Publication Date
2025-09-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This suggests that anal fissure physiopathology is more than just a crack or wound in the anal region.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: Chronic anal fissure (CAF), a painful condition linked to increased sphincter tone, is often treated with calcium channel blockers.
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Key Findings & Data:We excluded patients under 18, pregnant women, and those with prior treatments.
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Conclusion & Impact:This suggests that anal fissure physiopathology is more than just a crack or wound in the anal region.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:anal fissür · triticum vulgare · diltiazem

Abstract

Aim: Chronic anal fissure (CAF), a painful condition linked to increased sphincter tone, is often treated with calcium channel blockers. This study explored whether adding the wound-healing agent Triticum vulgare improves outcomes for these patients. Material and Methods: This study compared two groups of anal fissure patients: those treated with topical diltiazem alone versus diltiazem plus Triticum vulgare. We excluded patients under 18, pregnant women, and those with prior treatments. Data on demographics, comorbidities, and 1-month follow-up (bleeding, pain, and wound healing) were collected from hospital records and compared between the groups. Results: In the study including 91 patients, the median age was determined as 42. 58.2% (n = 53) of the patients were male. 21 patients (23.1%) received a combination therapy of Triticum vulgare plus topical diltiazem, while 70 patients (76.9%) were treated with topical diltiazem alone. At the end of one month, all patients in the case group had complete wound healing, while this rate was 82.9% in the control group (p = 0.042). Conclusion: When Triticum vulgare treatment was added to topical diltiazem treatment in the treatment of anal fissure, there was a decrease in the patients' bleeding and pain symptoms, but this was not statistically significant. However, wound healing was complete after 1 month in the Triticum vulgare added group and this change was found to be statistically significant. This suggests that anal fissure physiopathology is more than just a crack or wound in the anal region.

Özet

Amaç: Kronik anal fissür (KAF), artan sfinkter tonusuyla ilişkili ağrılı bir durum olup genellikle kalsiyum kanal blokerleri ile tedavi edilir. Bu çalışma, yara iyileştirici ajan Triticum vulgare'nin eklenmesinin bu hastalarda sonuçları iyileştirip iyileştirmediğini araştırmıştır. Gereç ve Yöntemler: Bu çalışma, anal fissür hastalarının iki grubunu karşılaştırdı: sadece topikal diltiazem ile tedavi edilenler ve diltiazem artı Triticum vulgare ile tedavi edilenler. 18 yaş altı hastalar, hamile kadınlar ve daha önce başka tedaviler almış hastalar çalışma dışı bırakıldı. Demografik veriler, komorbiditeler ve 1 aylık takip sonuçları (kanama, ağrı ve yara iyileşmesi) hastane kayıtlarından toplanarak gruplar arasında karşılaştırıldı. Bulgular: Çalışmaya dahil edilen 91 hastada medyan yaş 42 olarak belirlendi. Hastaların %58,2'si (n = 53) erkekti. 21 hasta (%23,1) Triticum vulgare artı topikal diltiazem kombinasyon tedavisi alırken, 70 hasta (%76,9) sadece topikal diltiazem ile tedavi edildi. 1 ayın sonunda, olgu grubundaki tüm hastalarda tam yara iyileşmesi gözlenirken, bu oran kontrol grubunda %82,9 idi (p = 0,042). Sonuç: Anal fissür tedavisinde topikal diltiazem tedavisine Triticum vulgare tedavisinin eklenmesiyle hastaların kanama ve ağrı semptomlarında azalma oldu ancak bu istatistiksel olarak anlamlı değildi. Ancak, Triticum vulgare eklenen grupta 1 ay sonra yara iyileşmesi tamdı ve bu değişiklik istatistiksel olarak anlamlı bulundu. Bu durum, anal fissür fizyopatolojisinin sadece anal bölgedeki bir çatlaktan veya yaradan daha fazlası olduğunu düşündürmektedir.

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Cite This Article

Ocaklı, S., Canlıkarakaya, F., Doğan, İ., Özmen, S. N., Çınkıl, N. C., Ceylan, C. (2025). Enhanced healing and pain relief in anal fissure treatment: evaluating the role of triticum vulgare in conjunction with diltiazem cream. Turkish Journal of Clinics and Laboratory, Cilt: 16 Sayı: 3, 540–544. https://doi.org/10.18663/tjcl.1750755

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References (18)

  1. Menteş B, Leventoğlu S. Chapter 3: Anal fissür. In: Menteş B, Bulut T, Alabaz Ö, Leventoğlu S eds. Anorektal Bölgenin Selim Hastalıkları. Türk Kolon ve Rektum Cerrahisi Derneği: 2011: 37-47.
  2. Gilani A, Tierney G. Chronic anal fissure in adults. BM. 2022; 376: e066834.
  3. Utzig MJ, Kroesen AJ, Buhr HJ. Concepts in pathogenesis and treatment of chronic anal fissure- a review of the literature. Am J Gastroenterol 2003; 98: 968-74.
  4. Schouten WR, Briel JW, Auwerda JJ, De Graaf EJ. Ischaemic nature of anal fissure. Br J Surg 1996; 83: 63-5.
  5. Poh A, Tan KY, Seow-Choen F. Innovations in chronic anal fissure treatment: A systematic review. World J Gastrointest Surg 2010; 2: 231-41.
  6. Davids JS, Hawkins AT, Bhama AR et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures. Dis Colon Rectum 2023; 66: 190-9.
  7. Sajid MS, Whitehouse PA, Sains P, Baig MK. Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure. Colorectal Dis 2013; 15: 19-26.
  8. Knight JS, Birks M, Farouk R. Topical diltiazem ointment in the treatment of chronic anal fissure. Br J Surg 2001; 88: 553-6.
  9. Canlıkarakaya F, Ocaklı S. Can Topical Glyceryl Trinitrate be Effective in the Treatment of Levator Ani Syndrome? Turk J Gastroenterol 2025; 36: 328-32.
  10. Tito A, Minale M, Riccio S, Grieco F, Colucci MG, Apone F. A Triticum vulgare Extract Exhibits Regenerating Activity During the Wound Healing Process. Clin Cosmet Investig Dermatol 2020; 13: 21-30.
  11. Ersan Y, Yavuz N, Çiçek Y, Ergüney S, Kuşaslan R. Anal fissürlerde medikal tedavi. Cerrahpaşa Tıp Dergisi 2004; 35.
  12. Şahin AG, Sayan İ, Alçı E, Can topical applicatıons be an alternative to surgery in the treatment of chronic anal fissures? Dicle Tıp Dergisi 2024; 51: 215-21.
  13. Newman M, Collie M. Anal fissure: diagnosis, management, and referral in primary care. Br J Gen Pract 2019; 69: 409-10.
  14. Pasha M, Sushanth PT, Reddy GV, Subshini TU. Management of Chronic Fissure in Ano with 2% Diltiazem Local Application (or) Lateral Internal Sphincterotomy: A Comparative Study. Res J Med Sci 2024; 18: 297-300.
  15. Bulus H, Varol N, Tas A, Coskun A. Comparison of topical isosorbide mononitrate, topical diltiazem, and their combination in the treatment of chronic anal fissure. Asian J Surg 2013; 36: 165-9.
  16. Ala S, Saeedi M, Hadianamrei R, Ghorbanian A. Topical diltiazem vs. topical glyceril trinitrate in the treatment of chronic anal fissure: a prospective, randomized, double- blind trial. Acta Gastroenterol Belg 2012; 75: 438-42.
  17. Kujur ADS, Paul Ekka NM, Chandra S, Lal S, Malua S. Comparative Study to Assess the Effectiveness of Topical Nifedipine and Diltiazem in the Treatment of Chronic Anal Fissure. J Family Med Prim Care 2020; 9: 5652-7.
  18. Bielecki K, Kolodziejczak M. A prospective randomized trial of diltiazem and glyceryltrinitrate ointment in the treatment of chronic anal fissure. Colorectal Dis 2003; 5: 256-7.