Effectivenss of using glycerin trinitrate solution for patients with anal fissures

The article considers the possibilities of improving the results of treatment of patients with acute anal fissures by using glycerin trinitrate. It studies the results of clinical and functional examination and treatment of 29 patients with acute anal fissures who were administered local introduction of 2,0 ml of 0,1% glycerin trinitrate solution as the basic component of the treatment regimen twice a day during 14-28 days. The aggregate treatment used a traditional complex of medical therapy of anal fissures using spasmolytics, medicines mproving microcirculation, nonsteroida! anti-inflammatory drugs, venotonics (in case of hemorrhoids) as well as physical treatment and local application of suppositories. The use of the proposed regimen of medical therapy allowed to achieve healing of the acute anal fissures and clinical recovery in 75,9% of the observed cases. The reasons for unsatisfactory treatment results were studied with account of the clinical data and results of the functional survey of the rectal closing apparatus. The analysis of the results has shown that the success of the treatment depends on the disease duration, intensity of sclerotic changes in the fissure edges and the concomitant proctologic pathology. The choice of indications for use of glycerin trinitrate, treatment period, doses and frequency of application should be made depending on the stage of the disease and availability of the sphincter spasm.