Abstract
Background: An anal fissure is a tear of the anal canal mucosa, located just distal to the mucocutaneous junction and usually in the posterior midline, mostly due to passage of a hard stool, explosive diarrhea or may be due to the strain of childbirth. Anal fissure is one of the most common lesions to reflect on the differential diagnosis of anal pain. Objective: This study aimed to compare the efficacy of lateral internal Sphincterotomy with chemical (topical 0.2% Glycerltrinitrate ointment) Sphincterotomy for the treatment of chronic anal fissure. Methodology: Convenience sampling (non-probability sampling technique) was used to select the study population. The study design was randomized control trial. Duration of this study was 1 year in which a total of 30 patients with symptom of anal fissure were observed. Results: In this study, the mean age was 30 years with a standard deviation ± 2.16. Thirteen (43%) patients were male and 17(57%) were female. Eleven (35%) patients were single and 19(65%) were married. Eighteen (60%) patients had medical treatment while 12(40%) had surgical treatment. Data was analyzed after a randomly patients follow-up study period (1 year) was analyzed as in two groups; Sphincterotomy Group 11 (70%) reported pain during defecation, 6(40%) bleeding, and 10 (68%) healing whereas in Glyceryl trinitrate GTN Group 5(30%) pain defecation, 9 (60%) bleeding, and 5 (32%) healing. Conclusion: Topical glyceryl trinitrate GTN is an effective treatment for the majority of patients with anal fissure in our population. Acute fissures respond very well to glyceryl trinitrate GTN whereas almost two third of chronic fissures respond to this conservative approach.

Key words: Anal fissure, GTN, Sphincterotomy