Aim: To evaluate conservative management as first line of management   for fissure in ano

Objective: 1–To study the efficacy of conservative management and                                 operative management

MATERIAL AND METHODS:
200 patients with symptoms of fissure in ano studied. Detailed history and thorough clinical examination of these patients was carried out. Conservative management with 0.3% nifedipine was used for local application and response assessed once every two weeks for a total of six months. Visual analogue scoring was used to assess pain. Lateral sphincterotomy was performed on patients not responding to conservative management.

RESULT:
A total of 190 patients conservatively managed of which 11 had recurrence of symptoms. Ten patients needed surgery.

CONCLUSION:
0.3% nifedipine therapy should be advocated as the first line of treatment for anal fissures, cost effective treatment and surgery restricted for cases resistant to medical management