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J R Soc Med. 1987 May; 80(5): 296–298.
PMCID: PMC1290813

Maintenance therapy with unprocessed bran in the prevention of acute anal fissure recurrence.


The effect of unprocessed bran in a dose of 5 g three times daily and a dose of 2.5 g three times daily for one year on the recurrence rate of anal fissures was studied in a double-blind, placebo-controlled trial in 90 patients with recently healed acute posterior anal fissures. Fifteen patients (16.6%) were withdrawn before the code was broken due to failure to follow the trial protocol for various reasons. Significantly fewer recurrences occurred in patients receiving bran 5 g three times daily (recurrence rate 16%, 95% confidence limits, 4.54 to 36.08) when compared with patients receiving bran 2.5 g three times daily (60%; 38.67 to 78.87) (P less than 0.01) and with patients receiving placebo three times daily (68%; 46.50 to 85.05) (P less than 0.01). No significant difference in recurrences was found between patients on bran 2.5 g and those on placebo.

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Selected References

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  • Jensen SL. Treatment of first episodes of acute anal fissure: prospective randomised study of lignocaine ointment versus hydrocortisone ointment or warm sitz baths plus bran. Br Med J (Clin Res Ed) 1986 May 3;292(6529):1167–1169. [PMC free article] [PubMed]
  • Jensen SL, Lund F, Nielsen OV, Tange G. Lateral subcutaneous sphincterotomy versus anal dilatation in the treatment of fissure in ano in outpatients: a prospective randomised study. Br Med J (Clin Res Ed) 1984 Sep 1;289(6444):528–530. [PMC free article] [PubMed]
  • Taylor I, Duthie HL. Bran tablets and diverticular disease. Br Med J. 1976 Apr 24;1(6016):988–990. [PMC free article] [PubMed]
  • Moesgaard F, Nielsen ML, Hansen JB, Knudsen JT. High-fiber diet reduces bleeding and pain in patients with hemorrhoids: a double-blind trial of Vi-Siblin. Dis Colon Rectum. 1982 Jul-Aug;25(5):454–456. [PubMed]
  • Painter NS, Almeida AZ, Colebourne KW. Unprocessed bran in treatment of diverticular disease of the colon. Br Med J. 1972 Apr 15;2(5806):137–140. [PMC free article] [PubMed]

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