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Nicorandil associated anal ulceration
1Department of Gastroenterology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK. a.j.watson@abdn.ac.uk
Summary
Nicorandil, a medication for angina, can cause anal ulcers. These ulcers healed in all patients after discontinuing nicorandil, suggesting a direct link.
Area of Science:
- Cardiology
- Gastroenterology
- Pharmacology
Background:
- Nicorandil is a vasodilator prescribed for angina.
- Nicorandil has been linked to oral and anal ulceration.
- Ulceration typically resolves upon drug discontinuation.
Purpose of the Study:
- To investigate the association between nicorandil use and anal ulceration.
- To describe the clinical and histological features of these ulcers.
- To evaluate the efficacy of drug withdrawal in healing these ulcers.
Main Methods:
- A case series of 13 patients with nonspecific anal ulceration was reviewed.
- All patients were undergoing treatment with nicorandil for ischemic heart disease.
- Clinical and histological data of the ulcers were analyzed.
Main Results:
- All 13 patients presented with similar clinical and histological ulcer appearances.
- Ulcer healing was observed in all patients after nicorandil withdrawal.
- No other interventions were noted as primary healing factors.
Conclusions:
- Nicorandil is a potential cause of anal ulceration.
- Consider nicorandil in the differential diagnosis of nonhealing anal ulcers.
- Drug withdrawal is an effective treatment for nicorandil-induced anal ulcers.