Gastroenterology ·
Topical sucralfate improved short-term healing of chronic anal fissures
A single-center, double-blind randomized trial of 82 adults compared topical 3% sucralfate-containing formulation with 0.2% nitroglycerin. Healing was more frequent with sucralfate at two and four weeks, while pain and quality-of-life improvements were comparable.
- Trial randomized 82 adults with chronic anal fissure.
- Two-week healing: 50% with sucralfate versus 23% with nitroglycerin.
- Four-week healing: 79% versus 48%, respectively.
- Pain and quality-of-life improvements were comparable.
Chronic anal fissures can involve elevated resting anal pressure and impaired tissue healing. In this single-center, double-blind randomized trial, 82 adults were assigned to apply either a 3% sucralfate-containing topical formulation or 0.2% nitroglycerin ointment to the fissure twice daily. The primary endpoint was healing at two weeks; secondary endpoints included four-week healing, pain, quality of life and recurrence. Median age was 46 years, and median symptom duration was eight weeks.
At two weeks, healing was observed in 21 of 42 patients receiving sucralfate (50%) and 9 of 40 receiving nitroglycerin (23%; RR 2.22, 95% CI 1.16–4.26; P=0.010). At four weeks, the corresponding figures were 33 of 42 (79%) and 19 of 40 (48%; RR 1.65, 95% CI 1.15–2.38; P=0.004). Pain reduction and quality-of-life improvement were comparable. Recurrence was reported in 5 of 27 patients (19%) in the sucralfate group and 4 of 17 (24%) in the nitroglycerin group; the difference was not statistically significant.
The findings suggest greater short-term healing with the sucralfate formulation in this trial, but the small, single-center study and limited follow-up constrain broader conclusions. The source does not report longer-term outcomes or establish whether the formulation should replace existing treatment approaches.
In practice
For adults with chronic anal fissure, this single-center randomized trial found more fissures healed with a 3% sucralfate-containing topical formulation than with 0.2% nitroglycerin at two and four weeks. Pain and quality-of-life improvements were similar, and recurrence did not differ significantly among those assessed. These results are promising but come from only 82 patients with short follow-up; they do not establish longer-term effectiveness or justify a change in treatment practice on their own.
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The American Journal of Gastroenterology: 3% Sucralfate-Containing Topical Formulation Versus 0.2% Topical Nitroglycerin for Chronic Anal Fissure: A Double-Blind Randomized Controlled Trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.