Conservative treatment of acute thrombosed external hemorrhoids with topical nifedipine

PURPOSE: This study was performed according to a prospective, randomized, o pen design. The aim was to test the efficacy of local application of nifedi pine ointment in healing acute thrombosed external hemorrhoids. METHODS: Ni nety-eight patients who gave their informed consent were recruited; they re ceived clinical examination and anoscopy. A questionnaire to evaluate sympt oms, pain, and concurrent use of analgesics was administered. Patients trea ted with nifedipine (n = 50) used topical 0.3 percent nifedipine and 1.5 pe rcent lidocaine ointment every 12 hours for two weeks. The control group, c onsisting of 48 patients, received topical 1.5 percent lidocaine ointment d uring therapy. RESULTS: Results obtained were as follows: complete relief o f pain in 43 patients (86 percent) of the nifedipine-treated group as oppos ed to 24 patients (50 percent) of the control group after 7 days of therapy (P < 0.01); oral analgesics were used by 4 patients (8 percent) in the nif edipine-treated group as opposed to 26 patients (54.1 percent) of the contr ol group after 7 days of therapy (P < 0.01); and resolution of acute thromb osed external hemorrhoids was achieved after 14 days of therapy in 46 patie nts (92 percent) of the nifedipine-treated group, as opposed to 22 patients (45.8 percent) of the control group (P < 0.01). We did not observe any sys temic side effect in patients treated with nifedipine. CONCLUSIONS: Our stu dy clearly demonstrates that the use of topical nifedipine, which at presen t is for treatment of cardiovascular disorders, is a reliable new option in the conservative treatment of thrombosed external hemorrhoids.