Article:
Comparison of fissure healing and the incidence of headache among the patients treated with endo- and perianal application of 0.2% glyceryl trinitrate for chronic anal fissure

creativeworkseries.issnJNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
dc.contributor.authorRaj Joshi, Mukund
dc.contributor.authorBohara, Tanka Prasad
dc.contributor.authorRupakheti, Shail
dc.creator.affiliationDepartment of Surgery, Kathmandu Medical College Sinamangal, Kathmandu, Nepal.
dc.creator.affiliationDepartment of Surgery, Kathmandu Medical College Sinamangal, Kathmandu, Nepal.
dc.creator.affiliationDepartment of Surgery, Kathmandu Medical College Sinamangal, Kathmandu, Nepal.
dc.date.accessioned2026-09-23T05:19:33Z
dc.date.available2026-09-23T05:19:33Z
dc.date.issued2016
dc.description.abstractAbstract Introduction: Chronic anal fissure is associated with significant morbidity and reduction in quality of life mostly in young healthy adults. Glyceryl Trinitrate, a most commonly used agent for treatment, is associated with incidence of headache causing discontinuation of treatment. There is belief that endoanal application instead of perianal is associated with lower incidence of headache. This study is to compare the incidence and severity of headache in between perianal and endoanal application of GTN ointment. Methods: Thirty patients were taken in each perianal and endoanal group. They were given orientation to apply 375gm of ointment either endoanally or perianally and to record severity of headache according to visual analogue scale. This record was noted by independent observer in telephonic conversation. Patients were followed up at 6 weeks for evaluation fissure. Results: The mean age, male female ratio and features of chronicity was similar in both the group however the duration of symptoms between the group was different. Regarding outcome, Overall incidence of headache was seen in two-third of patient with severe headache in approx. 10%. Severity of headache was slightly lower in endoanal group but the difference was not significant. Healing rate was comparable. Two patient in perianal and 3 in endoanal group were lost for follow up. Conclusions: Endoanal application of GTN ointment is associated with slight decrease in intensity of headache and is comparable with perianal application for fissure healing. Keywords: Anal fissure; Endoanal; Glyceryl trinitrate;Headache; Perianal.
dc.identifier.doihttps://doi.org/10.31729/jnma.2878
dc.identifier.urihttps://hdl.handle.net/20.500.14572/7834
dc.language.isoen_US
dc.publisherNepal Medical Association
dc.subjectAnal fissure
dc.subjectEndoanal
dc.subjectGlyceryl Trinitrate
dc.subjectHeadache
dc.subjectPerianal
dc.titleComparison of fissure healing and the incidence of headache among the patients treated with endo- and perianal application of 0.2% glyceryl trinitrate for chronic anal fissure
dc.typeArticle
dspace.entity.typePublication
local.article.typeOriginal Article
oaire.citation.endPage50
oaire.citation.startPage45
relation.isJournalIssueOfPublication3e275c6a-dbf5-4d1f-a727-9578861bc697
relation.isJournalIssueOfPublication.latestForDiscovery3e275c6a-dbf5-4d1f-a727-9578861bc697
relation.isJournalOfPublicatione6e146a0-0ece-4aba-aa0a-6ccfbd10a12a

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