Vol. 7, Issue 1, Part A (2025)

Background: Anal fissures in children, often due to constipation, cause significant discomfort. Treatment includes stool softeners, sitz baths, and topical medications. While 2% lidocaine gel provides symptom relief, 0.4% glyceryl trinitrate (GTN) ointment aids healing by reducing sphincter pressure. However, studies comparing their efficacy in pediatric patients are limited. This study aimed to evaluate the clinicodemographic profile and treatment outcomes among children with anal fissures. 
Methods: This prospective, comparative study was conducted at the Outpatient Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 2022 to August 2023. A total of 52 children aged 3 to 16 years with anal fissures were enrolled and equally divided into two groups: Group I received 0.4% GTN ointment, and Group II received 2% lidocaine gel. Standard conservative management was provided to both groups. Treatment outcomes were assessed at 1, 4, and 8 weeks. Data analysis was performed using SPSS version 23.0. 
Results: The mean age was 6.56±3.06 years in Group I and 7.6±2.61 years in Group II. Female predominance was noted in both groups. Perianal pain was present in all cases, with constipation affecting 88.5% in Group I and 73.1% in Group II. At 8 weeks, complete healing was significantly higher in Group I (80.8%) compared to Group II (26.9%) (p<0.05). Headache (15.4%) and postural hypotension (7.7%) were reported as side effects in Group I. 
Conclusion: 0.4% GTN ointment was more effective in achieving symptomatic relief and complete healing of anal fissures compared to 2% lidocaine gel. However, the potential side effects of GTN should be considered.