Efficacy and side effects of glyceryl trinitrate in management of chronic anal fissure

ABSTRACT

Various options are available for treatment of chronic anal fissure, each with its own associated complications. This study aimed to evaluate the efficacy of topical Glyceryl Trinitrate [GTN] for anal fissures in an outpatient setting. A prospective experimental study was carried out at the outpatient department of Surgical Unit IV, Liaquat University Hospital from Aug 2004 to Jul 2005. Total 100 patients fulfilling the criteria of chronic anal fissure were included in the study. Patients presenting with chronic anal fissure but with associated comorbidities were excluded. Data were collected on a designed questionnaire, and analysed using SPSS-10. Sixty women and 46 men were included in the study with a mean age of 30 years. After the end of 8 weeks of treatment, 76 showed healing of fissure and relief in symptoms whereas 20 patients either had improvement in symptoms or did not heal. The commonest side-effect was headache reported by 21 patients. The minimum period of follow-up was one year, and 7 patients had recurrence. Topical 0.2% GTN is an effective first-line agent in managing chronic anal fissure. The associated side effects and recurrence remains a matter of concern.