Background: Fissure is a common chronic anorectal disease that causes symptoms such as pain, burning, bleeding, and psychiatric problems. One of the psychiatric complications is anxiety, which might be an etiologic factor or secondary to the disease.
Materials and Methods: A total of 160 patients with anal fissure were randomly divided into two groups (80 patients treated with anti-anxiety medications along with standard anal fissure treatment and 80 patients with standard anal fissure treatment alone) after obtaining patient consent and demographic data. Then, the symptoms have recorded after treatment.
Results: The results of our study indicated that the administration of anti-anxiety medications in patients with anal fissures relieved pain and anxiety scores among all patients. The anti-anxiety medications were more effective on patients younger than 40 years, men with less than two weeks duration of illness, and baseline anxiety greater than 26.
Conclusion: A high prevalence of anal fissures affects the quality of life of patients. Besides the lack of effective treatment that shortens the pain and recovers patients faster, anti-anxiety medications such as benzodiazepines can use along with standard anal fissure treatment to reduce pain and anxiety in patients with acute anal fissure.
- Beaty J, Shashidharan M. Anal Fissure. Clin Colon Rectal Surg. 2016;29(01):030–7. doi: 10.1055/s-0035-1570390
- Emile SH, Elgendy H, Elfeki H, Magdy A, Abdelmawla AA, Abdelnaby M, et al. Does the duration of symptoms of anal fissure impact its response to conservative treatment? A prospective cohort study. Int J Surg. 2017;44:64–70.doi: 10.1016/j.ijsu.2017.06.044
- Zaghiyan K, Fleshner P. Anal Fissure. Clin Colon Rectal Surg . 2011;24(01):022–30. doi:10.1055/s-0031-1272820
- Schlichtemeier S, Engel A. Anal fissure. Aust Prescr. 2016;39(1):14–7.doi: 10.18773/austprescr.2016.007
- Mapel DW, Schum M, Von Worley A. The epidemiology and treatment of anal fissures in a population-based cohort. BMC Gastroenterol. 2014;14(1):2–8.
- Griffin N, Acheson AG, Tung P, Sheard C, Glazebrook C, Scholefield JH, et al. Quality of life in patients with chronic anal fissure. Color Dis. 2004;6(1):39–44.doi: 10.1111/j.1463-1318.2004.00576.x
- M.A. Raisolsadat, H.R Arshadi, M. Javanbakht BJE. On the relationship between anxiety and anal fissure Mohammad. J Fundam Ment Heal. 2009;1:69–74.
- Myles PS. The Pain Visual Analog Scale: Linear or Nonlinear?. Anesthesiology. 2004;100(3):744.doi: : 10.1097/00000542-200403000-00042
- Gholami Booreng F, Mahram B, Kareshki H. Construction and Validation of a Scale of Research Anxiety for Students. Iran J Psychiatry Clin Psychol. 2017;23(1):78–93.doi: 10.18869/nirp.ijpcp.23.1.78
- Marteau TM, Bekker H. The development of a sixitem short form of the state scale of the Spielberger State—Trait Anxiety Inventory (STAI). Br J Clin Psychol. 1992;31(3):301–6.doi: 10.1111/j.2044-8260.1992.tb00997.x
- SPIELBERGER, D. C. Manual for the State-trait Anxietry, Inventory. Consult Psychol.2021
- Arısoy Ö, Şengül N, Çakir A. Stress and psychopathology and its impact on quality of life in chronic anal fissure (CAF) patients. Int J Colorectal Dis. 2017;32(6):921–4.doi: 10.1007/s00384-016-2732-1
- Hang MTH, Smith BE, Keck C, Keshavarzian A, Sedghi S. Increasing efficacy and reducing side effects in treatment of chronic anal fissures. Med (United States). 2017;96(20).doi: 10.1097/MD.0000000000006853
- Burston JJ, Valdes AM, Woodhams SG, Mapp PI, Stocks J, Watson DJG, et al. The impact of anxiety on chronic musculoskeletal pain and the role of astrocyte activation. Pain. 2019;160(3):658–69.doi: 10.1097/j.pain.0000000000001445
- Westbrook L, Cicala RS, Wright H. Effectiveness of alprazolam in the treatment of chronic pain: Results of a preliminary study. Vol. 6, Clinical Journal of Pain. 1990:32–6.doi: 10.1097/00002508-199003000-00006