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Topical mononitrate treatment in patients with anal fissure
Author(s) -
Tankova L.,
Yoncheva K.,
Muhtarov M.,
Kadyan H.,
Draganov V.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2002.01145.x
Subject(s) - medicine , anal fissure , placebo , surgery , isosorbide mononitrate , anal canal , anesthesia , rectum , alternative medicine , pathology
Aim: To assess the efficacy and patient compliance of topical mononitrate hydrogel for the treatment of anal fissure. Materials and methods: Nineteen patients with symptomatic chronic anal fissures were randomly allocated to receive either active (10 patients) or placebo (nine patients) gel treatment. Rectal administration of hydrogel containing 0.2% isosorbide‐5‐mononitrate was prescribed. Patients were instructed on its application to the anal canal twice daily for 3 weeks. A questionnaire was used to determine patient compliance with therapy. Anal manometry was performed before and after therapy. Results: At the end of therapy, the fissures were healed in 80% of actively treated patients compared with 22% of the control group. There was a mean reduction of 28% in mean resting anal pressure. Two actively treated patients (20%) suffered from mild headache relieved with oral analgesics and menthol lozenges. Faecal incontinence was not observed. There were no recurrences during at least 3 months of follow‐up. Conclusions: Topical mononitrate gel therapy of anal fissures is an effective and safe approach. In this study, the few cases of headache were rapidly relieved with oral analgesia and menthol lozenges.