Nicorandil related anal ulcer.
BACKGROUND
Anal ulceration is uncommon. Patients are typically referred because of severe anal pain, bleeding, discharge, and ulceration. It is important to exclude anal carcinoma, and to consider more unusual causes.


METHODS
A 74-year-old lady presented with severe anal pain and ulceration. This was subsequently noted to be related to nicorandil, a potassium channel activator used in the treatment of angina. Discontinuation of nicorandil and faecal diversion allowed symptom relief and ulcer healing.


CONCLUSIONS
Knowledge of the association between nicorandil and anal ulceration is essential in order to appropriately diagnose and manage this condition.
Al-Hilli
Z
Z
Dept of Colorectal Surgery, Beaumont Hospital, Dublin 9.
Pritchard
R
R
Roche-Nagle
G
G
Deasy
J
J
McNamara
D A
DA
D000368:Aged; D005260:Female; D005401:Fissure in Ano / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D006801:Humans; D017202:Myocardial Ischemia / Q000188:drug therapy*; D020108:Nicorandil / Q000009:adverse effects*; D014665:Vasodilator Agents / Q000009:adverse effects*
D014665:Vasodilator Agents; D020108:Nicorandil