Rectogesic® (glyceryl trinitrate 0.2%) ointment relieves symptoms of haemorrhoids associated with high resting anal canal pressures

Tjandra, Joe J.; Tan, Jane J. Y.; Lim, Jit-Fong; Murray-Green, Carolyn; Kennedy, Michael L.; Lubowski, David Z.

doi:10.1111/j.1463-1318.2006.01134.x

Cited by 37 publications

(23 citation statements)

References 36 publications

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“…GTN did not contribute any additional complications. Interestingly despite reducing anal sphincter tone as demonstrated in previous studies, 26,27 transient minor incontinence did not differ between the two groups.…”

Section: Discussionsupporting

confidence: 65%

“…This issue could have been overcome by providing the control group with a placebo ointment to apply in a similar manner, resulting in both groups experiencing the same degree or reduction in anal spasm, which could be relieved by medications such as diazepam. 26,27 GTN has a direct action on anal sphincter muscles and as a consequence acts by reducing the pressure of the anal canal and the hypertonicity of the internal anal sphincter. 27 The internal anal sphincter is relaxed and the anoderm blood flow is increased, thus resulting in decreased pain and increased healing.…”

Section: Discussionmentioning

confidence: 99%

“…26,27 GTN has a direct action on anal sphincter muscles and as a consequence acts by reducing the pressure of the anal canal and the hypertonicity of the internal anal sphincter. 27 The internal anal sphincter is relaxed and the anoderm blood flow is increased, thus resulting in decreased pain and increased healing. 25,27 An unexpected finding was that our GTN patients, who had residual perianal skin tags excised, had more pain than those who did not, whereas there was no difference in the control patients, whether or not residual perianal skin tags were excised.…”

Section: Discussionmentioning

confidence: 99%

“…27 The internal anal sphincter is relaxed and the anoderm blood flow is increased, thus resulting in decreased pain and increased healing. 25,27 An unexpected finding was that our GTN patients, who had residual perianal skin tags excised, had more pain than those who did not, whereas there was no difference in the control patients, whether or not residual perianal skin tags were excised. Although the findings of statistical subset analysis need to be interpreted with caution, it is possible that the relatively smaller amount of tissue excised when removing residual skin tags compared with a formal excisional hemorrhoidectomy may make the differences between the 2 groups less clear.…”

Section: Discussionmentioning

confidence: 99%

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Glyceryl Trinitrate Ointment Did Not Reduce Pain After Stapled Hemorrhoidectomy: A Randomized Controlled Trial

Cross

Bartlett

Mushaya

et al. 2012

International Surgery

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Medications, including topical 0.2% glyceryl trinitrate (GTN), can reduce anal spasm and pain after excisional hemorrhoidectomy. GTN after stapled hemorrhoidopexy was compared with routine postoperative management. Patients with symptomatic grade 3/4 hemorrhoids were recruited. After stapled hemorrhoidopexy, residual perianal skin tags were excised as appropriate. Those requiring double purse-string mucosectomy were excluded. Postoperative pain, pain duration, and complications were assessed. One hundred ten patients (74 men; mean age 50.6 years) were enrolled in the control group and 100 patients (57 men; mean age 49.8 years) in the GTN group. Maximum pain was higher in the GTN group (P = 0.015). There were no differences between the two groups in residual perianal skin tags requiring excision, postoperative complications, recurrence rates, follow-up period, average pain, duration of pain, or satisfaction scores. Sixteen GTN patients were noncompliant due to side effects. None had persistent perianal skin tags. GTN did not reduce postoperative pain after stapled hemorrhoidectomy.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Glyceryl Trinitrate Ointment Did Not Reduce Pain After Stapled Hemorrhoidectomy: A Randomized Controlled Trial

Cross

Bartlett

Mushaya

et al. 2012

International Surgery

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“…Topical treatments like nitroglycerin ointment, topical nifedipine ointment have been used. 11 However the therapeutic effects of these agents are not significant so as to advocate them in routine clinical practice for treatment of piles.…”

Section: Managementmentioning

confidence: 99%

Hemorrhoids: which is the best therapeutic option?

et al. 2018

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Hemorrhoids are one of the commonest of rectal diseases seen all across the globe. Constipation and bleeding are the main symptoms associated with this condition. The condition maybe associated with an underlying carcinoma as well. Understanding the pathophysiology will enable the surgeon to determine the best therapeutic option for this condition. A brief review of clinical evaluation and treatment options is presented in this paper.

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Organic Nitrate Metabolism and Action: Toward a Unifying Hypothesis and the Future—A Dedication to Professor Leslie Z. Benet

Page

Fung

2013

Journal of Pharmaceutical Sciences

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This review summarizes the major advances that had been reported since the outstanding contributions that Professor Benet and his group had made in the 1980’s and 1990’s concerning the metabolism and pharmacologic action of organic nitrates (ORN). Several pivotal studies have now enhanced our understanding of the metabolism and the bioactivation of ORN, resulting in the identification of a host of cysteine-containing enzymes that can carry out this function. Three isoforms of aldehyde dehydrogenase, all of which with active catalytic cysteine sites, are now known to metabolize, somewhat selectively, various members of the ORN family. The existence of a long-proposed but unstable thionitrate intermediate from organic nitrate metabolism has now been experimentally observed. ORN-induced thiol oxidation in multiple proteins, called the “Thionitrate Oxidation Hypothesis”, can be used not only to explain the phenomenon of nitrate tolerance, but also the various consequences of chronic nitrate therapy, viz., rebound vasoconstriction, and increased morbidity and mortality. Thus, a unifying biochemical hypothesis can account for the myriad of pharmacological events resulting from nitrate therapy. Optimization of future uses of ORN in cardiology and other diseases could benefit from further elaboration of this unifying hypothesis.

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Rectogesic® (glyceryl trinitrate 0.2%) ointment relieves symptoms of haemorrhoids associated with high resting anal canal pressures

Abstract: Rectogesic is a safe and feasible treatment for patients with early grade haemorrhoids associated with high resting anal canal pressures.

Cited by 37 publications

References 36 publications

Glyceryl Trinitrate Ointment Did Not Reduce Pain After Stapled Hemorrhoidectomy: A Randomized Controlled Trial

Glyceryl Trinitrate Ointment Did Not Reduce Pain After Stapled Hemorrhoidectomy: A Randomized Controlled Trial

Hemorrhoids: which is the best therapeutic option?

Organic Nitrate Metabolism and Action: Toward a Unifying Hypothesis and the Future—A Dedication to Professor Leslie Z. Benet

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