Isosorbide dinitrate in the treatment of anal fissure: a randomised, prospective, double blind, placebo-controlled trial.
OBJECTIVE
To assess the efficacy of isosorbide dinitrate in healing anal fissures.


METHODS
Randomised, prospective, double blind, placebo controlled trial.


METHODS
Teaching hospital, The Netherlands.


METHODS
37 consecutive subjects with anal fissure diagnosed in the surgical outpatient department.


METHODS
After randomisation, 20 patients were given isosorbide dinitrate, and 17 patients placebo.


METHODS
Healing of anal fissure, recurrence, and tolerance.


RESULTS
Both groups were treated for a median (range) of 5 weeks (range 1-10). After this period, 17 in the isosorbide group had healed compared with 6 controls (p < 0.003). The fissure recurred in 2 patients who had had an initial good response to isosorbide, and in 2 in the control group. Side effects (particularly headache) were more common after isosorbide dinitrate, but not significantly so (9/20 compared with 3/17).


CONCLUSIONS
Isosorbide dinitrate is an effective treatment for anal fissure, and is significantly better than placebo.
Werre
A J
AJ
Department of Surgery, University Hospital St. Radboud, Arnhem, The Netherlands.
Palamba
H W
HW
Bilgen
E J
EJ
Eggink
W F
WF
D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate