In addition to systemic form of CCBs, topical form of them such as diltiazem gel is also being available. Previous studies introduced this form of diltiazem as a vasodilator, mostly, for treatment of chronic anal fissure [9]. Comparing its effects with topical nitrate for chronic anal fissures showed some controversies. Some studies resulted in no significant difference between them; yet, the study by Ala et al, demonstrated that diltiazem gel has superiority to nitroglycerin ointment [10, 11]. Another survey, in spite of finding non- significant difference between these two agents in treatment of anal fissure, gave priority to diltiazem gel because of headache induced by nitroglycerin ointment [12].