Audit of topical glyceryl trinitrate for treatment of fissure-in-ano

H. Hasegawa, S. Radley, D. G. Morton, N. J. Dorricott, D. J. Campbell, M. R B Keighley

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: To clarify the clinical role of topical glyceryl trinitrate (GTN) in the management of anal fissures. Patients and Methods: Fifty-six consecutive patients with fissure-in-ano attending a colorectal clinic from April 1997 to May 1998 included 16 acute and 40 chronic anal fissures. Patients were instructed to apply 0.2% 0.5 g of GTN to the painful area of the anus. Patients were followed-up in the clinic at 4, 8 and 12 weeks, and by telephone interviews at a median follow up of 10 months. Results: Ten of 16 acute fissures (63%) were healed by 4 weeks and 13 (81%) by 8 weeks. Thirteen of 40 chronic fissures (33%) were healed by 8 weeks and 20 (50%) by 12 weeks. Seventeen patients (30%) underwent lateral sphincterotomy and all healed. There were five recurrences within 3 months of treatment with GTN. Thirty-four (61%) suffered from headaches, eight being severe headaches. None of the patients developed incontinence with GTN or lateral sphincterotomy. Conclusions: Treatment of fissure-in-ano using GTN ointment was effective in up to 50% of patients with chronic anal fissure, and has the benefit of being repeatable if the fissure recurs. Patients should be aware that treatment is likely to take some months to be effective and is associated with significant side effects in up to 15% of patients.

Original languageEnglish
Pages (from-to)27-30
Number of pages4
JournalAnnals of the Royal College of Surgeons of England
Volume82
Issue number1
Publication statusPublished - 2000 Jan
Externally publishedYes

Fingerprint

Fissure in Ano
Nitroglycerin
Therapeutics
Headache
Anal Canal
Ointments
Interviews
Recurrence

Keywords

  • Anal fissure
  • Glyceryl trinitrate
  • Lateral sphincterotomy

ASJC Scopus subject areas

  • Surgery

Cite this

Hasegawa, H., Radley, S., Morton, D. G., Dorricott, N. J., Campbell, D. J., & Keighley, M. R. B. (2000). Audit of topical glyceryl trinitrate for treatment of fissure-in-ano. Annals of the Royal College of Surgeons of England, 82(1), 27-30.

Audit of topical glyceryl trinitrate for treatment of fissure-in-ano. / Hasegawa, H.; Radley, S.; Morton, D. G.; Dorricott, N. J.; Campbell, D. J.; Keighley, M. R B.

In: Annals of the Royal College of Surgeons of England, Vol. 82, No. 1, 01.2000, p. 27-30.

Research output: Contribution to journalArticle

Hasegawa, H, Radley, S, Morton, DG, Dorricott, NJ, Campbell, DJ & Keighley, MRB 2000, 'Audit of topical glyceryl trinitrate for treatment of fissure-in-ano', Annals of the Royal College of Surgeons of England, vol. 82, no. 1, pp. 27-30.
Hasegawa H, Radley S, Morton DG, Dorricott NJ, Campbell DJ, Keighley MRB. Audit of topical glyceryl trinitrate for treatment of fissure-in-ano. Annals of the Royal College of Surgeons of England. 2000 Jan;82(1):27-30.
Hasegawa, H. ; Radley, S. ; Morton, D. G. ; Dorricott, N. J. ; Campbell, D. J. ; Keighley, M. R B. / Audit of topical glyceryl trinitrate for treatment of fissure-in-ano. In: Annals of the Royal College of Surgeons of England. 2000 ; Vol. 82, No. 1. pp. 27-30.
@article{778fcccd249842c7a317dd0ecbc7cea7,
title = "Audit of topical glyceryl trinitrate for treatment of fissure-in-ano",
abstract = "Purpose: To clarify the clinical role of topical glyceryl trinitrate (GTN) in the management of anal fissures. Patients and Methods: Fifty-six consecutive patients with fissure-in-ano attending a colorectal clinic from April 1997 to May 1998 included 16 acute and 40 chronic anal fissures. Patients were instructed to apply 0.2{\%} 0.5 g of GTN to the painful area of the anus. Patients were followed-up in the clinic at 4, 8 and 12 weeks, and by telephone interviews at a median follow up of 10 months. Results: Ten of 16 acute fissures (63{\%}) were healed by 4 weeks and 13 (81{\%}) by 8 weeks. Thirteen of 40 chronic fissures (33{\%}) were healed by 8 weeks and 20 (50{\%}) by 12 weeks. Seventeen patients (30{\%}) underwent lateral sphincterotomy and all healed. There were five recurrences within 3 months of treatment with GTN. Thirty-four (61{\%}) suffered from headaches, eight being severe headaches. None of the patients developed incontinence with GTN or lateral sphincterotomy. Conclusions: Treatment of fissure-in-ano using GTN ointment was effective in up to 50{\%} of patients with chronic anal fissure, and has the benefit of being repeatable if the fissure recurs. Patients should be aware that treatment is likely to take some months to be effective and is associated with significant side effects in up to 15{\%} of patients.",
keywords = "Anal fissure, Glyceryl trinitrate, Lateral sphincterotomy",
author = "H. Hasegawa and S. Radley and Morton, {D. G.} and Dorricott, {N. J.} and Campbell, {D. J.} and Keighley, {M. R B}",
year = "2000",
month = "1",
language = "English",
volume = "82",
pages = "27--30",
journal = "Annals of the Royal College of Surgeons of England",
issn = "0035-8843",
publisher = "Royal College of Surgeons of England",
number = "1",

}

TY - JOUR

T1 - Audit of topical glyceryl trinitrate for treatment of fissure-in-ano

AU - Hasegawa, H.

AU - Radley, S.

AU - Morton, D. G.

AU - Dorricott, N. J.

AU - Campbell, D. J.

AU - Keighley, M. R B

PY - 2000/1

Y1 - 2000/1

N2 - Purpose: To clarify the clinical role of topical glyceryl trinitrate (GTN) in the management of anal fissures. Patients and Methods: Fifty-six consecutive patients with fissure-in-ano attending a colorectal clinic from April 1997 to May 1998 included 16 acute and 40 chronic anal fissures. Patients were instructed to apply 0.2% 0.5 g of GTN to the painful area of the anus. Patients were followed-up in the clinic at 4, 8 and 12 weeks, and by telephone interviews at a median follow up of 10 months. Results: Ten of 16 acute fissures (63%) were healed by 4 weeks and 13 (81%) by 8 weeks. Thirteen of 40 chronic fissures (33%) were healed by 8 weeks and 20 (50%) by 12 weeks. Seventeen patients (30%) underwent lateral sphincterotomy and all healed. There were five recurrences within 3 months of treatment with GTN. Thirty-four (61%) suffered from headaches, eight being severe headaches. None of the patients developed incontinence with GTN or lateral sphincterotomy. Conclusions: Treatment of fissure-in-ano using GTN ointment was effective in up to 50% of patients with chronic anal fissure, and has the benefit of being repeatable if the fissure recurs. Patients should be aware that treatment is likely to take some months to be effective and is associated with significant side effects in up to 15% of patients.

AB - Purpose: To clarify the clinical role of topical glyceryl trinitrate (GTN) in the management of anal fissures. Patients and Methods: Fifty-six consecutive patients with fissure-in-ano attending a colorectal clinic from April 1997 to May 1998 included 16 acute and 40 chronic anal fissures. Patients were instructed to apply 0.2% 0.5 g of GTN to the painful area of the anus. Patients were followed-up in the clinic at 4, 8 and 12 weeks, and by telephone interviews at a median follow up of 10 months. Results: Ten of 16 acute fissures (63%) were healed by 4 weeks and 13 (81%) by 8 weeks. Thirteen of 40 chronic fissures (33%) were healed by 8 weeks and 20 (50%) by 12 weeks. Seventeen patients (30%) underwent lateral sphincterotomy and all healed. There were five recurrences within 3 months of treatment with GTN. Thirty-four (61%) suffered from headaches, eight being severe headaches. None of the patients developed incontinence with GTN or lateral sphincterotomy. Conclusions: Treatment of fissure-in-ano using GTN ointment was effective in up to 50% of patients with chronic anal fissure, and has the benefit of being repeatable if the fissure recurs. Patients should be aware that treatment is likely to take some months to be effective and is associated with significant side effects in up to 15% of patients.

KW - Anal fissure

KW - Glyceryl trinitrate

KW - Lateral sphincterotomy

UR - http://www.scopus.com/inward/record.url?scp=0033958405&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033958405&partnerID=8YFLogxK

M3 - Article

C2 - 10700763

AN - SCOPUS:0033958405

VL - 82

SP - 27

EP - 30

JO - Annals of the Royal College of Surgeons of England

JF - Annals of the Royal College of Surgeons of England

SN - 0035-8843

IS - 1

ER -