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In one review, calcium channel blockers were shown to be as effective as topical nitrates. Anal fistulas are a complication of anorectal abscesses, which are more common in women than in men. When a high fistula is identified, the first step is often placement of a seton, a suture, or other material now commonly a Silastic vessel loop that is passed though the fistula track, out the anus, and secured to itself. Relationship between anal symptoms and anal findings. J Am Coll Surg. A probe is inserted in the external opening of one fistula. Oral and topical calcium channel blockers diltiazem and nifedipine have been shown to be effective treatment options for anal fissures.
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