Topical Nitroglycerin Therapy for Anal Fissures and Ulcers

To the Editor: Myenteric nerves innervating the internal sphincter muscle of the anus produce and release nitric oxide, 1 , 2 the chemical messenger that mediates relaxation of this muscle. 1 A derangement in nitric oxide regulation may underlie the anal-sphincter hypertonicity associated with anal...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 333; no. 17; pp. 1156 - 1157
Main Author Gorfine, Stephen R
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 26.10.1995
Subjects
Administration, Topical
Adult
Anus Diseases - drug therapy
Female
Fissure in Ano - drug therapy
Humans
Male
Nitroglycerin - therapeutic use
Pain - drug therapy
Ulcer - drug therapy
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Summary:To the Editor: Myenteric nerves innervating the internal sphincter muscle of the anus produce and release nitric oxide, 1 , 2 the chemical messenger that mediates relaxation of this muscle. 1 A derangement in nitric oxide regulation may underlie the anal-sphincter hypertonicity associated with anal fissures and ulcers. Nitroglycerin, which is locally metabolized to nitric oxide, lowers the mean resting pressure of the anal sphincter when applied topically to the anus. 3 A pilot study of 15 patients showed that topical nitroglycerin was useful in treating anal fissures and ulcers. 4 Forty patients with anal fissures (26 women and 14 men; mean age, 38 years) . . .
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ISSN:0028-4793
1533-4406
DOI:10.1056/NEJM199510263331718