What the guidelines say
Clinical practice guidelines of the American Society of Colon and Rectal Surgeons and of European and Latin American colorectal societies recommend, for chronic anal fissure: fiber and sitz baths as the base; topical nitroglycerin or a topical calcium channel blocker (diltiazem or nifedipine) as first-line medical therapy; botulinum toxin as second line; and lateral internal sphincterotomy as the most effective treatment for fissures that fail medical therapy.
What trials show about nifedipine
- Topical nifedipine lowers resting anal pressure and heals chronic fissures at rates comparable to nitroglycerin, with far fewer headaches, in randomized trials.
- Nifedipine combined with lidocaine has been evaluated in randomized studies showing healing and pain control in the first weeks superior to lidocaine alone.
- Systemic absorption of topical nifedipine is minimal; blood pressure changes are not observed in healthy adults.
We cite guideline statements and trial findings in general terms on this page; the full reference list is available to physicians and pharmacists on request through the professionals contact.
Our clinical experience
Clínica Proctológica de Lima treats anorectal conditions exclusively. FISURIN was formulated for post-operative fissures and then extended to acute and chronic fissures in consultation. Internal results are being compiled for publication; we do not publish cure percentages until they are audited.