A randomised, prospective, double-blind, placebo-controlled trial of glyceryl trinitrate ointment in treatment of anal fissure

Lancet
J N Lund, J H Scholefield

Abstract

Anal fissure is most commonly treated surgically by internal anal sphincterotomy. However, there is some concern over the effects of this procedure on continence. Nitric oxide donors such as glyceryl trinitrate (GTN) have been shown to cause a reversible chemical sphincterotomy capable of healing fissures in a small series of cases. This study reports a prospective, randomised, double-blind, placebo-controlled trial to test the hypothesis that topical GTN is the best first-line treatment for chronic anal fissure. 80 consecutive patients were randomised to receive treatments with topical 0.2% GTN ointment or placebo. Maximum anal resting pressure (MARP) was measured with a constantly perfused side-hole catheter before and after the first application of trial ointment. Anodermal blood flow was measured during manometry by laser Doppler flowmetry. After initial treatments, patients were given a supply of ointment (either GTN or placebo) to be applied to the lower anal canal twice daily. Patients were reviewed 2-weekly. At the initial and follow up visits patients were asked to record pain experienced on defaecation on a linear analogue pain score. Endpoints were healing of the fissure or condition after 8 weeks of treatment. After...Continue Reading

References

May 1, 1977·The British Journal of Surgery·M R Lock, J P Thomson
May 1, 1989·The British Journal of Surgery·I T Khubchandani, J F Reed
Jun 1, 1986·The British Journal of Surgery·C P Gibbons, N W Read
Oct 26, 1995·The New England Journal of Medicine·S R Gorfine
May 1, 1995·Diseases of the Colon and Rectum·S R Gorfine
Oct 1, 1994·Diseases of the Colon and Rectum·A H SultanC I Bartram
Sep 1, 1994·The British Journal of Surgery·P B LoderR K Phillips
Jul 1, 1994·American Heart Journal·N J Mangione, S P Glasser
Sep 9, 1993·The American Journal of Cardiology·H L Fung
Jan 1, 1996·The British Journal of Surgery·W R SchoutenE J De Graaf
Jun 1, 1996·The British Journal of Surgery·S J WatsonR K Phillips
Nov 1, 1996·The British Journal of Surgery·D P Edwards, E M Chisholm

❮ Previous
Next ❯

Citations

Jan 4, 1998·Diseases of the Colon and Rectum·D R Littlejohn, G L Newstead
Nov 17, 2001·Diseases of the Colon and Rectum·M JonasJ H Scholefield
Sep 6, 2001·Diseases of the Colon and Rectum·M JonasJ H Scholefield
Apr 6, 2001·Diseases of the Colon and Rectum·P PerrottiM Antropoli
May 29, 2000·Diseases of the Colon and Rectum·G Maria, G Brisinda
May 1, 1999·Diseases of the Colon and Rectum·N H Hyman, P A Cataldo
Aug 24, 1999·Diseases of the Colon and Rectum·G DorfmanC Platell
Jun 23, 1999·Diseases of the Colon and Rectum·T A CookN J Mortensen
Dec 22, 1998·Diseases of the Colon and Rectum·F Delcò, A Sonnenberg
Mar 25, 2000·Diseases of the Colon and Rectum·T A Cook, N J Mortensen
Dec 6, 2005·Irish Journal of Medical Science·H N SimmsR J Moorehead
Jul 30, 2005·International Journal of Colorectal Disease·Jonathan N Lund
Apr 22, 2006·International Journal of Colorectal Disease·Hiroko KidoTomohiro Naruse
Nov 19, 2003·Langenbeck's Archives of Surgery·A G Acheson, J H Scholefield
Aug 7, 2007·Techniques in Coloproctology·E E Collins, J N Lund
May 4, 2011·Techniques in Coloproctology·D F AltomareR D Villani
Mar 3, 2004·Diseases of the Colon and Rectum·Richard Nelson
Nov 13, 2004·Diseases of the Colon and Rectum·Ian LindseyNeil J Mortensen
Dec 29, 2004·Diseases of the Colon and Rectum·Ian LindseyNeil J McC Mortensen
Mar 5, 2005·Diseases of the Colon and Rectum·M P GosselinkW R Schouten
Apr 7, 2005·Diseases of the Colon and Rectum·Rogelio GarridoCarlos Garcia
Apr 15, 2006·Diseases of the Colon and Rectum·Luis Torrabadella, Gervasio Salgado
May 4, 2007·Diseases of the Colon and Rectum·Daniel L AzarnoffDavid Karlin
Apr 16, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Michele Schiano di Visconte, Gabriele Munegato
May 15, 2003·Current Treatment Options in Gastroenterology·Miguel MinguezAdolfo Benages
May 29, 2000·American Journal of Surgery·S Argov, O Levandovsky
Jan 5, 2002·Obstetrics and Gynecology·J L Pfenninger, G G Zainea
Apr 20, 2001·European Journal of Obstetrics, Gynecology, and Reproductive Biology·R PelegI Z Ben-Zion
Jun 8, 2001·Gastroenterology Clinics of North America·M Jonas, J H Scholefield
Nov 18, 1999·Clinical Privilege White Paper
Jan 6, 2001·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·G BassottiM A Pelli

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