Efficacy of Verapamil Combined with Zinc Oxide for Anal Fissure Management

Haifa T. Abu  Tbeekh; Hamoodi Aliwi  Mosa; Mohammed Hamoudi  Alsunboli

doi:10.36371/port.2024.special.42

Authors

Haifa T. Abu Tbeekh College of Pharmacy, Uruk University, Baghdad, Iraq.
Hamoodi Aliwi Mosa College of Pharmacy, Uruk University, Baghdad, Iraq.
Mohammed Hamoudi Alsunboli College of Dentistry, University of Al-Bayan, Baghdad, Iraq.

Abstract References Downloads Cite Statistics Share Information

Anal fissure are common causes of rectal bleeding; often necessitate effective local medicinal treatments to avoid surgical intervention. This study evaluates the efficacy of a novel combination therapy using verapamil and zinc oxide ointment for the management of chronic anal fissure. Verapamil, a calcium channel blocker, reduces sphincter pressure, while zinc oxide promotes healing through its anti-inflammatory properties. Conducted as a prospective randomized controlled trial, 65 patients were divided into three groups: a control group treated with Vaseline, a group treated with 15% verapamil ointment, and a group treated with 15% verapamil ointment and 10% zinc oxide ointment. Over a six-week period, the combination therapy group demonstrated significantly higher healing rates and pain relief compared to the other groups. The results suggest that verapamil combined with zinc oxide is a promising and effective treatment option for chronic anal fissures, with manageable side effects.

Keywords:

Chronic Anal Fissure, Verapamil, Zinc Oxide, Topical Treatment, , Calcium Channel Blocker

[1] Gardner, Ivy H., Ragavan V. Siddharthan, and Vassiliki Liana Tsikitis. "Benign anorectal disease: hemorrhoids, fissures, and fistulas." Annals of gastroenterology 33, no. 1 (2020): 9. nih.gov

[2] Rao, S. S. C. and Tetangco, E. P. "Anorectal disorders: an update." Journal of Clinical Gastroenterology (2020). [HTML]

[3] Zuhan, Arif, Puji Widyastuti, Alfia Mawaddah, Annisa D. Indrasari, Baiq HS Alawiya, Putu D. Priyahita, I. Komang Yose Antara, Mervin Arifianto Manginte, Tomi Irmayanto, and IGM Sanies Ermawan. "Anal Fissure: Clinical Practice, Diagnosis in Primary Care and Management Guideline. A Literature Reviews." Lombok Health And Science Journal 3, no. 1 (2024): 24-35. unram.ac.id

[4] Cohee, M. W., Hurff, A., and Gazewood, J. D. "Benign anorectal conditions: evaluation and management." American Family Physician (2020). aafp.org

[5] Acar, T., N. Acar, F. Güngör, E. Kamer, H. Genç, K. Atahan, O. N. Dilek, and M. Hacıyanlı. "Comparative efficacy of medical treatment versus surgical sphincterotomy in the treatment of chronic anal fissure." Nigerian journal of clinical practice 23, no. 4 (2020): 539-544. lww.com

[6] Banerjee, Anupam, Pinaki Roy, Rajat Suvra Moral, and Swarup Chakraborty. "An observational study comparing and non-surgical treatment with surgical treatment for chronic anal fissures." Asian Journal of Medical Sciences 14, no. 1 (2023). [HTML]

[7] Hou, Rui, Yan He, Guangwei Yan, Shuzeng Hou, Zhouling Xie, and Chenzhong Liao. "Zinc enzymes in medicinal chemistry." European Journal of Medicinal Chemistry 226 (2021): 113877. [HTML]

[8] Gondal, Aqarab Husnain, Asma Zafar, D. Zainab, M. D. Toor, S. Sohail, S. Ameen, A. B. Ijaz et al. "A detailed review study of zinc involvement in animal, plant and human nutrition." Indian Journal of Pure & Applied Biosciences 9, no. 2 (2021): 262-271. researchgate.net

[9] Setareh Soltany, Babak Hosseinzadeh Zoroufchi. "Study the effect of zinc oxide ointment on symptoms arising from hemorrhoids and anal fissure." Journal of Critical Reviews 7, no. 1 (2020): 115-118. ISSN- 2394-5125

[10] Lo, Y., Lin, L. Y., and Tsai, T. F. "Use of calcium channel blockers in dermatology: a narrative review." Expert review of clinical pharmacology (2021). [HTML]

[11] Suza Ali H M, Al-Khedairy E B. Formulation and Evaluation of Prednisolone -Loaded Alginate Beads for Taste Masking. The Egyptian Journal of Hospital Medicine. 2023; 90 (2), Page 2178-2186. DOI: 10.21608/EJHM.2023.285683

[12] Suza Ali H M, Al-Khedairy E B. Formulation and In Vitro Evaluation of Taste- Masked Prednisolone Orodispersible Tablets. JFacMedBagdad. 2023; 65(3):192-8. https://doi.org/10.32007/jfacmedbagdad.2057

[13] Triboulet, S., Aude-Garcia, C., Armand, L., Gerdil, A., Diemer, H., Proamer, F., Collin-Faure, V., Habert, A., Strub, J. M., Hanau, D., Herlin, N., Carrière, M., Van Dorsselaer, A., and Rabilloud, T. "Analysis of cellular responses of macrophages to zinc ions and zinc oxide nanoparticles: a combined targeted and proteomic approach." (2014). [PDF]

[14] Hu, Z., Zhou, L., Meng, D., Zhao, L., Li, Y., Huang, Y., Wu, Y., Yang, S., Li, L., and Hong, Z. "Surface engineering for ultrathin metal anodes enabling high-performance Zn-ion batteries." (2022). [PDF]

[15] Jin, S. E. and Jin, H. E. "Synthesis, Characterization, and Three-Dimensional Structure Generation of Zinc Oxide-Based Nanomedicine for Biomedical Applications." (2019). ncbi.nlm.nih.gov

[16] Khabir, Z., M. Holmes, A., Lai, Y. J., Liang, L., Deva, A., A. Polikarpov, M., S. Roberts, M., and V. Zvyagin, A. "Human Epidermal Zinc Concentrations after Topical Application of ZnO Nanoparticles in Sunscreens." (2021). ncbi.nlm.nih.gov

[17] Younus,M.M, Ibtahim, I.R, Pharmacovigilance for herbal medicines in Iraq. In: Barnes, J. Pharmacovigilance for herbal and traditional medicines. Adis, Cham(2022). http://doi.org/10.1007/978-3-031-07275-8-25

PDF

Tbeekh, H. T. A. ., Mosa, H. A. ., & Alsunboli, M. H. . (2024). Efficacy of Verapamil Combined with Zinc Oxide for Anal Fissure Management. Journal Port Science Research, 7(issue), 545–548. https://doi.org/10.36371/port.2024.special.42