Researchers from Sofia, Bulgaria, assessed the efficacy and patient compliance of topical mononitrate hydrogel for the treatment of anal fissure.
A total of 19 patients with symptomatic chronic anal fissures were randomly allocated to receive either active (10 patients) or placebo (9 patients) gel treatment.
Rectal administration of hydrogel containing 0.2% isosorbide-5-mononitrate was prescribed.
Patients were instructed on its application to the anal canal twice daily for 3 weeks.
The researchers used a questionnaire to determine patient compliance with therapy. In addition, anal manometry was performed both before and after therapy.
|Healed anal fissures after therapy:|
Mononitrate gel: 80%
| Alimentary Pharmacology & Therapeutics |
At the end of therapy, the fissures were healed in 80% of actively treated patients, compared with 22% of the control group.
The team found that there was a mean reduction of 28% in mean resting anal pressure.
Two actively treated patients (20%) suffered from mild headache, which was relieved with oral analgesics and menthol lozenges.
The researchers did not observe fecal incontinence, and there were no recurrences during at least 3 months of follow-up.
Author L. Tankova, of the State University Hospital in Sofia, concluded on behalf of the group, "Topical mononitrate gel therapy of anal fissures is an effective and safe approach.
"In this study, the few cases of headache were rapidly relieved with oral analgesia and menthol lozenges."