Non surgical treatment of chronic anal fissure: one year`s experience with GTN paste

Objective: Assessment of the efficacy of topical 0.2% glyceryl trinitrate (GTN) paste in the treatment of chronic anal fissure. Patients and Methods: Sixty two patients were treated with 0.2% GTN paste and reviewed at 3, 6 and 12 weeks interval to assess efficacy and side effects. Results: At 6 weeks, 72% of patients were treated successfully. In 28% of cases treatment was unsuccessful. At 12weeks follow up there was no early recurrence. The prevalence of headaches was 70%. Conclusions: The use of GTN induces rapid healing of chronic anal fissures with a 72% healing rate in this study. But balance is required between fissure healing and headache intolerance.