title: [Favorable results of conservative treatment with isosorbide dinitrate in 25 patients with fourth-degree hemorrhoids: a pilot study].
abstract: OBJECTIVE
  To evaluate application of isosorbide dinitrate 1% ointment in the treatment of fourth-degree haemorrhoids.
  
  
  METHODS
  Prospective pilot study.
  
  
  METHODS
  Twenty-five consecutive patients, 12 men and 13 women, with a median age of 48 years (range: 30-78), presenting in the period October 1999-December 2001 with fourth-degree haemorrhoids, were treated with isosorbide dinitrate 1% ointment.
  
  
  RESULTS
  In 24 out of 25 patients (96%) the objective, reduction of the stangulated haemorrhoids and relief of pain, was achieved. In one patient the haemorrhoids were not reduced. This patient was cured after classic haemorrhoidectomy. Two patients interrupted the treatment because of severe headache, but after renewed instructions they continued the therapy and were cured.
  
  
  CONCLUSIONS
  Isosorbide dinitrate 1% ointment gave good results in the treatment of fourth-degree haemorrhoids, with only few side effects.
authors.affiliation: Maaslandziekenhuis Sittard, afd. Heelkunde, Postbus 5500, 6130 MB Sittard.
authors.forename: M
authors.initials: M
authors.lastname: van den Berg
authors.forename: H J G
authors.initials: HJ
authors.lastname: Stroeken
authors.forename: A G M
authors.initials: AG
authors.lastname: Hoofwijk
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D005260:Female; D006484:Hemorrhoids / Q000188:drug therapy*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010865:Pilot Projects; D011446:Prospective Studies; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D009824:Ointments; D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate