title: Glyceryl trinitrate treatment of chronic fissure in ano: one year's experience with 0.5% GTN paste.
abstract: OBJECTIVE
  Assessment of the efficacy of topical 0.5% glyceryl trinitrate (GTN) paste in the treatment of chronic fissures in ano.
  
  
  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.
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital, King's Lynn, UK.
authors.forename: F F
authors.initials: FF
authors.lastname: Palazzo
authors.forename: S
authors.initials: S
authors.lastname: Kapur
authors.forename: M
authors.initials: M
authors.lastname: Steward
authors.forename: P T
authors.initials: PT
authors.lastname: Cullen
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005996:Nitroglycerin