Enhanced healing and pain relief in anal fissure treatment: evaluating the role of triticum vulgare in conjunction with diltiazem cream

Aim: Chronic anal fissure (CAF), a painful condition linked to increased sphincter tone, is often treated with calcium channel blockers. This study explored whether adding the wound-healing agent Triticum vulgare improves outcomes for these patients. Material and Methods: This study compared two groups of anal fissure patients: those treated with topical diltiazem alone versus diltiazem plus Triticum vulgare. We excluded patients under 18, pregnant women, and those with prior treatments. Data on demographics, comorbidities, and 1-month follow-up (bleeding, pain, and wound healing) were collected from hospital records and compared between the groups. Results: In the study including 91 patients, the median age was determined as 42. 58.2% (n = 53) of the patients were male. 21 patients (23.1%) received a combination therapy of Triticum vulgare plus topical diltiazem, while 70 patients (76.9%) were treated with topical diltiazem alone. At the end of one month, all patients in the case group had complete wound healing, while this rate was 82.9% in the control group (p = 0.042). Conclusion: When Triticum vulgare treatment was added to topical diltiazem treatment in the treatment of anal fissure, there was a decrease in the patients' bleeding and pain symptoms, but this was not statistically significant. However, wound healing was complete after 1 month in the Triticum vulgare added group and this change was found to be statistically significant. This suggests that anal fissure physiopathology is more than just a crack or wound in the anal region.