**Nifedipine Gel with Lidocaine in the Treatment of Anal Fissure in Children: A Pilot Study and Review of the Literature**

Baruch Klin1, Ibrahim Abu-Kishk2, Yigal Efrati1 and Gad Lotan1 *1Department of Pediatric Surgery & 2Pediatric Intensive Care Unit, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel* 

### **1. Introduction**

52 Complementary Pediatrics

[39] Manley C. Elective general surgery at one year of age: psychological and surgical

[40] Freud S. A Case of Hysteria: Three Essays on Sexuality and Other Works. London:

considerations. Surg Clinics North Am 1982; 62: 941–53.

Hogarth Press, 1955.

Anal fissures are common in infancy and represent the most common cause of bright rectal bleeding at any age. Delayed diagnosis and treatment can lead to a disturbing cycle of constipation, repeat rectal bleeding, and crying, due to increasing pain during and after defecation. In spite of its high frequency, the problem remains underrated by most clinicians, with only a paucity of data on the management of anal fissures in children being found in the literature. The objective of this work is to bring this common and distressing problem into a more positive light, based on our good results achieved by the nifedipine gel with lidocaine treatment.
