Abstract | PURPOSE: METHODS:
Isosorbide dinitrate, Isoket spray (Schwarz-Pharma, Mannheim, Germany), was used to treat 41 patients with chronic anal fissure. Anal manometry was performed in all patients before they entered the study. The treatment program consisted of digital application of isosorbide dinitrate in a dose of 1.25 mg or 2.5 mg three times each day for four weeks. At the end of the trial, patients were followed up for an average time of 11 +/- 1 months. RESULTS: In 34 (83 percent) patients, the fissure healed within one month of treatment (mean, 3 +/- 0.1 weeks). The average time for symptoms to disappear was 6.5 +/- 0.7 days. In six (14.6 percent) patients the anal fissure did not heal even after four weeks of further treatment, and they underwent lateral sphincterotomy. Six patients relapsed during the follow-up period, but responded to another course of treatment. A dose of 2.5 mg of isosorbide dinitrate caused a greater reduction in maximum anal resting pressure than a dose of 1.25 mg. CONCLUSIONS: Topical isosorbide dinitrate is an effective and safe treatment for chronic anal fissure. In our experience the optimal dose regimen is 2.5 mg three times each day.
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Authors | J Lysy, Y Israelit-Yatzkan, M Sestiere-Ittah, D Keret, E Goldin |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 41
Issue 11
Pg. 1406-10
(Nov 1998)
ISSN: 0012-3706 [Print] United States |
PMID | 9823807
(Publication Type: Journal Article)
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Chemical References |
- Vasodilator Agents
- Isosorbide Dinitrate
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Topics |
- Administration, Topical
- Adolescent
- Adult
- Chronic Disease
- Female
- Fissure in Ano
(drug therapy)
- Humans
- Isosorbide Dinitrate
(administration & dosage, therapeutic use)
- Male
- Manometry
- Middle Aged
- Treatment Outcome
- Vasodilator Agents
(administration & dosage, therapeutic use)
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