Published: 2019-12-26

Use of diclofenac suppositories in pain management in acute fissure in ano in outpatient department care

Juthikaa Abhijit Deherkar


Background: Per anal diseases and the pain management in such cases have always been a problematic solution for surgeons. There are various pain management methods for per anal cases, however we wanted a cheaper yet effective way and patient friendly method for pain management where no expertise would be required, hence we opted to see results of diclofenac suppositories which were easily available, patient could insert it without anyone’s help or assistance and hence need not be hospitalized for any intravenous analgesics.

Methods: A study was conducted over 2000 cases over a span of 6 years in a tertiary centre. A control group A of 1000 patients was made where, oral (tablet diclofenac) plus local analgesics (xylocaine gel) were opted for whereas the other group B of 1000 patients was treated with diclofenac suppository 100 mg twice a day with glycerin as lubricant at anal verge. The pain score was noted in both the groups. All acute fissure in ano cases, we included in this study.

Results: The pain score of the group B cases was much lower than the group A cases, and also the duration of results acquired was much lesser than group A.

Conclusions: Diclofenac suppository 100 mg twice a day proved to be an excellent pain management method for acute fissure in ano cases in outpatient department care.


Acute fissure in ano, Diclofenac suppository, Per anal pain

Full Text:



Jensen SL. Diet and other risk factors for fissure-in-ano. Prospective case control study. Dis Colon Rectum. 1988;31(10):770–3.

Anal Fissure – Basics – Epidemiology. Best Practice. Br Med J. 1983;70(3):175-6.

Gough MJ, Lewis A. The conservative treatment of fissure-in-ano. Br J Surg. 1983;70(3):175-6.

Katsinelos P, Kountouras J, Paroutoglou G, Beltsis A, Chatzimavroudis G, Zavos C, et al. Aggressive Treatment of Acute Anal Fissure with 0.5% Nifedipine Ointment Prevents Its Evolution to Chronicity. World J Gastroenterol. 2006;12(38):6203–6.

Gupta PJ. Treatment of fissure in ano- revisited. Afr Health Sci. 2004;4:58–62.

Antropoli C, Perrotti P, Rubino M, Martino A, De Stefano G, Migliore G, et al. Nifedipine for Local Use in Conservative Treatment of Anal Fissures: Preliminary Results of a Multicenter Study. Dis Colon Rectum. 1999;42(8):1011-5.

Naz S, Memon NY, Sattar A, Baloch R Diclofenac rectal suppository: an effective modality for perineal pain. J Pak Med Assoc. 2016;66(8):1005-8.

Bushuven S, Heise D, Bolbrinker J. Diclofenac up2date - Part 1: Pharmacology and comparison with other drugs. Anasthesiol Intensivmed Notfallmed Schmerzther. 2014;49(10):588-98.

Bushuven S, Heise D, Bolbrinker J. Diclofenac up2date - Part 2: The use in specific groups of patients. Anasthesiol Intensivmed Notfallmed Schmerzther. 2014;49(11-12):670-9.