Diltiazem hydrochloride cream for treating anal fissures

Diltiazem hydrochloride cream is in clinical development for the treatment of chronic anal fissure. An anal fissure is a small tear or cut in the lining of the skin around the back passage (anus). The most common symptoms of anal fissures include pain around the anus and bleeding when passing stools. Anal fissures often arise from constipation, persistent diarrhoea, inflammatory bowel disease, pregnancy, and childbirth. The treatment options for anal fissures are generally based on reducing the anal pressures and include non-surgical and surgical modalities. Lateral internal sphincterotomy (surgical incision into one of the anal sphincter muscles) is used for definitive management of anal fissure though anal incontinence is a serious complication of the procedure. The only pharmacological treatment licensed in UK for treatment of chronic anal fissure is glyceryl trinitrate rectal ointment, however this is also associated with side effects.