0.4% Nitroglycerin Ointment in the Treatment of Chronic Anal Fissure Pain

摘要

Topical nitrates have become the first-line treatment for chronic anal fissure in most countries since 1997. Meta-analysis of all randomised trials of topical nitroglycerin demonstrates superiority over placebo. Professional body guidelines support the use of nitrates as initial treatment for chronic fissure in the UK, USA and Europe. In the UK, topical nitroglycerin has been the nitrate most commonly prescribed, but until 2005 it was prescribed off-licence and the ointment made in a number of different manufacturing hospital pharmacies. This meant that treatment was often available only in secondary care and sufferers from anal fissure had to wait several months before treatment could be commenced