The Effect of Asacol (Mesalazine) Suppository on the Healing of Acute Fissures Caused by Diarrhea: A Randomized Controlled Trial

Document Type : Research/Original Article

Authors

1 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Colorectal research center, Shiraz University of Medical Sciences, Shiraz, Iran

10.30476/acrr.2026.110177.1279

Abstract

Background: An anal fissure is a linear, superficial tear in the squamous epithelium of the anus, specifically in
the anoderm distal to the dentate line. Given the well-established anti-inflammatory properties of mesalazine in
acute conditions, it helps prevent secondary stricture and reduces the risk of complications such as incontinence
that may arise during fissure surgery. This study investigates the effect of Asacol (Mesalazine) suppositories in
the treatment of acute anal fissures caused by diarrhea, compared to a placebo.
Methods: This double-blind, randomized controlled clinical trial involved 69 patients aged 18 to 65 years
who experienced diarrhea followed by acute fissure symptoms lasting less than six weeks. Participants were
randomly assigned and blinded into two groups: 34 in the control group and 35 in the treatment group. Both
groups applied diltiazem ointment three times daily and took hot water basin baths twice daily. The control
group received a placebo, while the treatment group was administered Asacol suppositories. The primary
outcome measures were the degree of pain reduction and the speed of recovery.
Results: The findings indicated that the recovery rate in the experimental group (80%) was significantly higher
than in the control group (38.2%) (P<0.001). The current study also investigated the consumption of coffee and
the incidence of anal fissures, revealing that the likelihood of recovery was not associated with tea or coffee
consumption. Additionally, patient age showed no significant relationship with the chance of recovery; the
mean age of the study population was 43.49±15.08 years.
Conclusion: The findings of the current study indicate that Asacol suppositories have a significant effect on the
healing of acute anal fissures caused by diarrhea and can be considered a viable treatment option.

Highlights

Leila_Ghahramani (Google Scholar)

Hajar Khazraei (Google Scholar)

Keywords

References

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Iranian Journal of Colorectal Research
Volume 13, Issue 4
December 2025

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