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Demirli Atici, Semra, Canda, Aras, Terzi, Mustafa. (1404). Is L-Arginine Ready for Clinical Use in Chronic Anal Fissure?A Critical Appraisal of the Current Evidence. سامانه مدیریت نشریات علمی, 13(3), 109-110. doi: 10.30476/acrr.2026.110366.1281
Semra Demirli Atici; Aras Emre Canda; Mustafa Cem Terzi. "Is L-Arginine Ready for Clinical Use in Chronic Anal Fissure?A Critical Appraisal of the Current Evidence". سامانه مدیریت نشریات علمی, 13, 3, 1404, 109-110. doi: 10.30476/acrr.2026.110366.1281
Demirli Atici, Semra, Canda, Aras, Terzi, Mustafa. (1404). 'Is L-Arginine Ready for Clinical Use in Chronic Anal Fissure?A Critical Appraisal of the Current Evidence', سامانه مدیریت نشریات علمی, 13(3), pp. 109-110. doi: 10.30476/acrr.2026.110366.1281
Demirli Atici, Semra, Canda, Aras, Terzi, Mustafa. Is L-Arginine Ready for Clinical Use in Chronic Anal Fissure?A Critical Appraisal of the Current Evidence. سامانه مدیریت نشریات علمی, 1404; 13(3): 109-110. doi: 10.30476/acrr.2026.110366.1281

Is L-Arginine Ready for Clinical Use in Chronic Anal Fissure?A Critical Appraisal of the Current Evidence

Iranian Journal of Colorectal Research
دوره 13، شماره 3، آذر 2025، صفحه 109-110    اصل مقاله (462.78 K)
نوع مقاله: Letter to the Editor
شناسه دیجیتال (DOI): 10.30476/acrr.2026.110366.1281
نویسندگان
Semra Demirli Atici* 1؛ Aras Emre Canda2؛ Mustafa Cem Terzi2
1Acibadem Kent Hospital, Department of General Surgery, Izmir, Turkey
2KRC Clinic for Colorectal Surgery and Peritoneal Surface Malignancies, Izmir, Turkey
چکیده
Chronic anal fissure (CAF) is a common benign anorectal condition driven by internal anal sphincter hypertonicity and impaired anodermal perfusion, often resulting in persistent symptoms and high recurrence rates after medical therapy. L-arginine has recently been proposed as a conservative treatment option based on its role as a nitric oxide precursor and its potential to induce sphincter relaxation and improve local blood flow. This article provides a critical appraisal of the biological rationale and available clinical evidence supporting L-arginine in CAF management. Although early physiological studies and limited clinical trials suggest possible reductions in resting anal pressure and symptom improvement, the overall evidence remains limited and heterogeneous. Existing studies are constrained by small sample sizes, short follow-up, variable routes of administration, and non-standardized outcome measures, with a lack of direct comparisons to established first-line therapies such as topical nitrates or calcium channel blockers. Moreover, conflicting experimental data raise unresolved mechanistic questions regarding dosing, administration route, and patient selection. At present, L-arginine should be regarded as an investigational or adjunctive therapy rather than a validated alternative in routine CAF treatment. Well-designed randomized controlled trials with standardized endpoints and long-term follow-up are required to define its clinical role

تازه های تحقیق

Semra Demirli Atici (Googlescholar)

کلیدواژه‌ها
Fissure in Ano؛ Arginine؛ Anal Canal؛ Nitric Oxide
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