**15. Conclusions**

Topical 0.2% nifedipine with lidocaine appears today as the most efficient mode of treatment for anal fissures in children, with a significant healing rate and no side effects. It is safe and effective, prevents the evolution of acute anal fissures in children to chronicity, avoids surgical procedures in the great majority of cases, avoids complications and does not require hospitalization.

Nifedipine Gel with Lidocaine in the Treatment

(July 1997), pp. 840–845

(June 2000), pp. 861–868

No.2, (July 1999), pp. 65–69

(September 1979), pp. 484–490

(February 1996), pp. 212–216

1007–1010

*Gut*, Vol.44, No.5, (May 1999), pp. 727–730

*Therapeutics*, Vol.15, No.7, (July 2001), pp. 887–898

*Chirurgicum Neerlandicum,* Vol.29, No.3, (1977), pp. 163–166

Vol.42, No.8, (August 1999), pp. 1011–1015

*Surgery*, Vol.30, No.12, (December 2006), pp. 2246–2260

*Colon and Rectum*, Vol.41, No.5, (May 1998), pp. 606–611

of Anal Fissure in Children: A Pilot Study and Review of the Literature 67

Ayantude, A.A., & Debrah, S.A. (2006). Current concepts in anal fissures. *World Journal of* 

Bacher, H., Mischinger, H.J., Werkgartner, G., Cerwenka, H., El-Shabrawi, A., Pfeifer, J., &

Barrett, W.L., Callahan, T.D., & Orkin, B.A. (1998). Perianal manifestations of human

Bhardwaj, R., Vaizey, C.J., Boulos, P.B., & Hoyle C.H. (2000). Neuromyogenic properties of

Brisinda, G., Maria, G., Bentivoglio, A.R., Cassetta, E., Gui, D., & Albanese, A. (1999). A

Burleigh, D. E., D'Mello, A., & Parks, A. G. (1979). Responses of isolated human internal anal

Carapeti, E.A., Kamm, M.A., McDonald, P.J., Chadwick, S.J., Melville, D., & Phillips, R.K.

Chrysos, E., Xynos, E., Tzovaras, G., Zoras, O.J., Tsiaoussis, J., & Vassilakis, S.J. (1996). Effect

Cohen, A., & Dehn, T.C. (1995). Lateral subcutaneous sphincterotomy for treatment of anal fissure in children. *The British Journal of Surgery*, Vol.82, No.10, (October 1995), pp. 1341–1342 Cook, T.A., Brading, A.F., & Mortensen, N.J. (2001). The pharmacology of the internal anal

Cundall, J.D., Gardiner, A., Laden, G., Grout, P., & Duthie, G.S. (2003). Use of hyperbaric oxygen to treat chronic anal fissure. *The British Journal of Surgery*, Vol.90, No. 4, pp. 452–453 DeMoulin, D. (1977). A fundamental affair – a short history of anal fissure. *Archivum* 

Dorfman, G., Levitt, M., & Platell, C. (1999). Treatment of chronic anal fissure with topical

Eisenhammer, S. (1951). The surgical correction of chronic internal anal sphincteric contracture*. South African Medical Journal*, Vol.25, No.28, (July 1951), pp. 486-489 Ezri, T., & Susmallian. S. (2003). Topical nifedipine vs. topical glyceril trinitrate on chronic anal fissure. *Diseases of the Colon and Rectum*, Vol.46, No.6, (June 2003), pp. 805–808 Gillett, B.P., & Paidas, C.N. (2006), Anal fissure, In: *eMedicine*, Accessed 4th August, 2011, Available from: www.emedicine.medscape.com/article/934952-print Gosselink, M.P., Darby, M., Zimmerman, D.E., Gruss, H.J., & Schouten, W.R. (2005). Treatment

fissures: preliminary results of a multicenter study. *Diseases of the Colon and Rectum*,

Schweiger, W. (1997). Local nitroglycerin for treatment of anal fissures: an alternative to lateral sphincterotomy? *Diseases of the Colon & Rectum,* Vol.40, No.7,

immunodeficiency virus infection: experience with 260 patients. *Diseases of the* 

the internal anal sphincter: therapeutic rationale for anal fissures. *Gut*, Vol.46, No.6,

comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure. *The New England Journal of Medicine*, Vol.341,

sphincter to drugs and electrical field stimulation. *Gastroenterology*, Vol.77, No.3,

(1999). Randomised controlled trial shows that glyceryl trinitrate heals anal fissures, higher doses are not more effective, and there is a high recurrence rate.

of nifedipine on rectoanal motility. *Diseases of the Colon and Rectum*, Vol.39, No.2,

sphincter and new treatments of ano-rectal disorders. *Alimentary Pharmacology &* 

glyceryl trinitrate. *Diseases of the Colon and Rectum*, Vol.42, No.8, (August 1999), pp.

of chronic anal fissure by application of L-arginine gel : a phase II study in 15 patients. *Diseases of the Colon and Rectum*, Vol.48, No.4, (April 2005), pp. 832–837
