Topical 2 per cent diltiazem ointment used as an agent for chemical sphincterotomy for chronic anal fissure offers significant healing rates but does not have a significant side-effect profile, which may aid compliance to treatment. Early recurrences are common but usually amenable to further chemical sphincterotomy.

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Many anal fissures heal with topical treatment with GTN. Lateral internal sphincterotomy remains effective but should be reserved for patients who fail to respond to initial chemical sphincterotomy.

directly onto the electrode surface may also increase ks. It has been shown that adsorption of iron(III) protoporphyrin IX onto pyrolytic graphite resulted in a value of ks which exceeded 104

No abstract