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Glyceryl trinitrate treatment of chronic fissure in ano: one year's experience with 0.5% GTN paste
F F Palazzo1, S Kapur, M Steward
1Department of Surgery, Queen Elizabeth Hospital, King's Lynn, UK.
Objective:
Assessment of the efficacy of topical 0.5% glyceryl trinitrate (GTN) paste in the treatment of chronic fissures in ano.
Patients And Methods:
Forty-five patients were treated with 0.5% GTN paste and reviewed at 3, 6 and 12 weeks to assess symptoms, side effects and fissure healing.
Results:
At 6 weeks, 73% of patients had no fissures. In 27% of cases treatment was unsuccessful. At three month follow up there was no early recurrence. The prevalence of headaches was 84% with 11% headache related non-compliance.
Conclusions:
The use of 0.5% GTN induces rapid healing of chronic anal fissures with a 73% healing rate in this study. Successful treatment may come at the expense of a high incidence of headaches and a lower compliance than found in studies involving a lower concentration of GTN. A balance is required between fissure healing and headache intolerance.