Authors' objectives:

To assess the effectiveness and cost-effectiveness of glyceryl trinitrate for chronic anal fissures

Authors' recommendations: 0.2% glyceryl trinitrate (GTN) ointment is an unlicensed treatment for chronic anal fissures. The Committee agreed that GTN has a clinically important effect on healing and is a simple and cheap treatment. It often avoids the need for surgery, as well as the delay in waiting for surgical treatment. Evidence for the use of this treatment comes from 2 RCTs which are of good quality but have fairly small sample sizes. The Committee noted that a large UK trial is due to report later this year and asked to keep a watching brief in this area. The Committee noted that GTN is contraindicated for patients with certain conditions and for those taking sildenafil. Given concern about misdiagnosing potentially curable anorectal cancers, the Committee also stated that patients with chronic anal fissures should be positively diagnosed by full examination before receiving GTN treatment.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 1999

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Wessex Institute for Health Research and Development (WIHRD)