Comparison of topical glyceryl trinitrate ointment and oral nifedipine in the treatment of chronic anal fissure

Acta chirurgica Belgica
N A MustafaY Yücel

Abstract

This study was designed to compare the effect of topical glyceryl trinitrate (GTN) and oral nifedipine treatments on maximal anal resting pressure (MARP) and subsequently to assess their effectiveness in healing of chronic anal fissure (CAF). Patients were allocated randomly to receive either oral nifedipine retard (10 patients) 20 mg twice daily or instructed to apply glyceryl trinitrate (0.2 percent) ointment (10 patients) into the lower half of the anal canal twice daily. They were reviewed and assessed at the first visit and every fortnight for measurement of MARP, pain scores, blood pressure, pulse rate, healing of the fissure and adverse effects. Treatment were continued until healing had occurred or for up to 8 weeks. MARP values before and after application of the GTN ointment was 113.2 cm H2O and 72.5 cm H2O respectively (P < 0.001). Nifedipine caused a reduction in mean MARP from 105.2 to 74.0 cm H2O (P < 0.001). Linear analogue pain scores were significantly reduced after 2 weeks treatment with GTN and nifedipine (P < 0.001) and continued throughout the treatment period. At the end of the study; 7 of the 10 patients in the GTN group were deemed to be healed (5) or improved (2), compared with 6 of the 10 patients in t...Continue Reading

Citations

Feb 18, 2012·The Cochrane Database of Systematic Reviews·Richard L NelsonAbigail Jones
Aug 7, 2007·Techniques in Coloproctology·E E Collins, J N Lund
Jan 31, 2007·International Journal of Colorectal Disease·Th ScholzD Hahnloser
Jul 17, 2014·BMC Gastroenterology·Douglas W MapelAnn Von Worley
Aug 11, 2017·Techniques in Coloproctology·R L NelsonA Yeboah-Sampong

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