Anal fissure is a common ulcer that occurs in the anal canal and is characterized by itching, bleeding, pain, and the feeling of a lump or pulse after passing stool. Various treatment options are available for acute or chronic anal fissures, such as topical agents, but they are not very effective in treating chronic cases. Therefore, surgery has been the only effective treatment for chronic anal fissures. However, in recent years, there has been interest in developing effective topical formulations as less invasive strategies. Boron has shown some evidence of having anti-inflammatory and wound-healing effects, making it a potential treatment for chronic anal fissures. The current study utilized a boron-based topical formulation to treat chronic anal fissures.

The study was a prospective, randomized, double-blind, placebo-controlled, multi-centered trial conducted to examine the effectiveness of a boron-based ointment in treating chronic anal fissures. One hundred forty participants diagnosed with chronic anal fissures were randomly assigned to either the intervention or control group (87 women, 53 men, age range: 18-84 years, mean age: 47.2). Based on their groups, participants received boron-based ointment or a placebo for two weeks. The symptoms experienced by the participants before and after treatment, such as itching, bleeding, pain, and the feeling of a pulse or lump after defecation, as well as the presence of fissures, were compared between the intervention and control groups.

All evaluated symptoms, including pain and bleeding during anal examination, in the intervention group decreased significantly. After the treatment, only 15 patients (16.6%) had anal fissures in the intervention group, while 46 patients (92%) had fissures in the placebo group (p<0.001). None of the patients in the intervention group required surgery due to fissure disease, whereas 14 cases were referred for surgery in the placebo group.

After two weeks of treatment, the intervention group experienced a significant reduction in all symptoms. This suggests that the ointment could be a viable alternative to surgery for treating chronic anal fissures. However, further studies are necessary to confirm its effectiveness and determine its suitability for standard procedures in treating chronic fissures.