title: Isosorbide dinitrate in the treatment of anal fissure: a randomised, prospective, double blind, placebo-controlled trial.
abstract: 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.
authors: Department of Surgery, University Hospital St. Radboud, Arnhem, The Netherlands.
authors: A J
authors: AJ
authors: Werre
authors: H W
authors: HW
authors: Palamba
authors: E J
authors: EJ
authors: Bilgen
authors: W F
authors: WF
authors: Eggink
mesh_terms: 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*
chemical_list: D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate