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Rectal Nitroglycerin

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1. Chronic anal fissure: 0.2% topical glyceryl trinitrate ointment

for children (BNFc) or the MHRA or NICE websites for up-to-date information. Currently, 0.4% glyceryl trinitrate rectal ointment (Rectogesic 4 mg/g rectal ointment, ProStrakan) is the only licensed treatment for chronic anal fissure in the UK. It is indicated for the relief of pain associated with chronic anal fissure in adults, but is not licensed for children or young people under 18 years. T opical 0.2% glyceryl trinitrate ointment does not currently have a UK licence for treating chronic anal fissures (...) -of-rights). Page 2 of 29T opical 0.4% glyceryl trinitrate ointment (Rectogesic 4 mg/g rectal ointment, ProStrakan) is licensed in the UK for the relief of pain associated with chronic anal fissure in adults for a maximum of 8 weeks (see the Rectogesic 4 mg/g rectal ointment summary of product characteristics). It is not indicated for the healing of chronic anal fissure and is not recommended for use in children and young people under 18 years because of a lack of data on safety and efficacy. The summary

2013 National Institute for Health and Clinical Excellence - Advice

2. Topical Minoxidil Versus Topical Glyceryl Trinitrate in Treatment of Chronic Anal Fissure

and recurrence of anal fissure Condition or disease Intervention/treatment Phase Anal Fissure Drug: Minoxidil Drug: Glyceryl trinitrate Not Applicable Detailed Description: All participants who fulfill the inclusion criteria and give consent for participation in the trial and will be included and randomly assigned to either group I (5% Minoxidil gel) or group II (0.2% GTN cream) with a 1:1 allocation. Randomization will be carried out using online software (Research Randomizer Version 4.0 at https (...) % cream three times per days for 4 weeks Drug: Glyceryl trinitrate application of glyceryl trinitrate 0.2% cream three time per day on the anus for four weeks Other Name: Topical GTN treatment Outcome Measures Go to Primary Outcome Measures : Healing duration [ Time Frame: three months ] the duration of time needed for complete healing defined as reepithelialization of the anoderm at the site of anal fissure Secondary Outcome Measures : Anal pain [ Time Frame: three months ] degree of relief of anal

2018 Clinical Trials

3. Role of 0.4 % glyceryl trinitrate ointment after stapled trans-anal rectal resection for obstructed defecation syndrome: a prospective, randomized trial. (Abstract)

Role of 0.4 % glyceryl trinitrate ointment after stapled trans-anal rectal resection for obstructed defecation syndrome: a prospective, randomized trial. The anal fissure and spasm represent possible complications and causes of postoperative anal pain in patients that have undergone stapled trans-anal rectal resection (STARR). The etiology of these complications is still questioned such as the treatment modality. This study was designed to evaluate the effectiveness of topical glyceryl (...) trinitrate (GTN) 0.4 % in determining decrease of incidence of postoperative anal spams and fissure and reduction of early postoperative pain.From a total of 243 patients referred for obstructed defecation syndrome (ODS) 104 (42.7 %) underwent STARR and were randomized to receive (Group 1) or not (Group 2) topical 0.4 % GTN ointment every 12 h for four postoperative weeks. Postoperative evaluation was made at 1, 6, and 12 months.At 1 month follow-up, the incidence of anal spasm in Groups 1 and 2

2014 International journal of colorectal disease

4. Low-energy contact X-ray brachytherapy (the Papillon technique) for locally advanced rectal cancer

anaesthesia and glyceryl trinitrate are applied to the anal sphincter to numb the area and relax the sphincter muscles. A sigmoidoscope is inserted through the anal sphincter to ascertain the size and position of the tumour. Subsequently, a rigid endorectal treatment applicator is inserted and placed in contact with the tumour. A contact X-ray tube is introduced into the applicator and emits low- Low-energy contact X-ray brachytherapy (the Papillon technique) for locally advanced rectal cancer (IPG659) © (...) may be given. The aim is to reduce the tumour size, alleviate symptoms and improve quality of life. The procedure 2.3 Low-energy contact X-ray brachytherapy (CXB, or the Papillion technique) for locally advanced rectal cancer may be given with external beam radiotherapy or chemotherapy, or both. It is usually delivered in a day-patient setting. The patient is given an enema before treatment to empty the rectum. With the patient in a knee-to-chest, prone jack-knife or supine position, local

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

5. Glyceryl Trinitrate Ointment vs Posterior Tibial Nerve Stimulation in the Treatment of Anal Fissure

Glyceryl Trinitrate Ointment vs Posterior Tibial Nerve Stimulation in the Treatment of Anal Fissure Glyceryl Trinitrate Ointment vs Posterior Tibial Nerve Stimulation in the Treatment of Anal Fissure - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Glyceryl Trinitrate Ointment vs Posterior Tibial Nerve Stimulation in the Treatment of Anal Fissure The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02700438 Recruitment Status : Completed First Posted : March 7, 2016 Last Update Posted : March 7, 2016

2016 Clinical Trials

6. Rectal Nitroglycerin

Aka: Rectal Nitroglycerin , Glyceryl Trinitrate , Rectiv From Related Chapters II. Indications III. Preparations Glyceryl Trinitrate ointment 0.2% to 0.4% (Compounded by pharmacies) Nitroglcycerin ointment 0.4% (Rectiv) IV. Dosing Apply twice daily for 6 weeks V. Mechanism Chemical sphincterotomy Reduces maximal anal resting pressure VI. Adverse effects Severe (25%) Apply with glove or finger cot to prevent absorption Start at 25-50% of typical dose and advance VII. Drug Interactions s (e.g (...) . ) Contraindicated in combination VIII. Efficacy Study of 80 patients over 8 weeks Fissures healed in 68% using glyceryl ointment Adverse effects: Only 8% healed with standard delivery IX. References (2012) Presc Lett 19(1): 3 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Rectal Nitroglycerin." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Cost: Medications

2018 FP Notebook

7. A Multicenter, Prospective, Randomized Controlled Trial Evaluating the Efficacy of Rectal Diclofenac and Sublingual Nitroglycerin as a Combined Prophylactic Treatment for Post-ERCP Pancreatitis. (Abstract)

A Multicenter, Prospective, Randomized Controlled Trial Evaluating the Efficacy of Rectal Diclofenac and Sublingual Nitroglycerin as a Combined Prophylactic Treatment for Post-ERCP Pancreatitis. Acute pancreatitis is the major complication of endoscopic retrograde cholangiopancreatography (ERCP). A preliminary research suggested that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) with nitroglycerin might reduce the incidence of post-ERCP pancreatitis (PEP) more effectively (...) than NSAIDs alone. We conduct a two-arm, multicenter, prospective, randomized, superiority trial to evaluate the additional effect of nitroglycerin for prevention of PEP. A total of 900 patients randomly receive 50 mg diclofenac suppository either alone or with 5 mg isosorbide dinitrate sublingual tablet. The primary endpoint is the occurrence of PEP. This study will clarify whether NSAIDs plus nitroglycerin can prevent PEP.

2016 Acta medica Okayama Controlled trial quality: uncertain

8. Perianal versus endoanal application of glyceryl trinitrate 0.4% ointment in the treatment of chronic anal fissure: results of a randomized controlled trial. Is this the solution to the headaches? Retraction. (Abstract)

Perianal versus endoanal application of glyceryl trinitrate 0.4% ointment in the treatment of chronic anal fissure: results of a randomized controlled trial. Is this the solution to the headaches? Retraction. 23652758 2013 07 29 2019 02 25 1530-0358 56 6 2013 Jun Diseases of the colon and rectum Dis. Colon Rectum Perianal versus endoanal application of glyceryl trinitrate 0.4% ointment in the treatment of chronic anal fissure: results of a randomized controlled trial. Is this the solution (...) to the headaches? Retraction. 802 10.1097/DCR.0b013e318295d95c Madoff Robert D RD eng Retraction of Publication United States Dis Colon Rectum 0372764 0012-3706 Pérez-Legaz J, Arroyo A, Moya P, Ruiz-Tovar J, Frangi A, Candela F, Oliver MI, Calpena R. Dis Colon Rectum. 2012 Aug;55(8):893-9 22810476 2013 5 9 6 0 2013 5 9 6 0 2013 7 31 6 0 ppublish 23652758 10.1097/DCR.0b013e318295d95c 00003453-201306000-00019

2013 Diseases of the colon and rectum Controlled trial quality: uncertain

9. Commissioning guide for rectal bleeding

test to check whether there is blood hidden in faeces flexible sigmoidoscopy telescope examination of the lower bowel full blood count (FBC) a blood test for anaemia Glyceryl trinitrate (GTN) medication to relax the anal sphincter and improve blood supply to allow fissure healing haemorrhoidal artery ligation operation doppler guided haemorrhoidal operation designed to identify and tie off blood vessels haemorrhoids piles high value care pathway clear and consistent commissioning guideline (...) haemorrhoids should be given advice about topical treatment, oral fluid intake, high fibre diet and fibre supplementation. 12 Consideration should be given to referral to a specialist community or secondary care provider of colorectal services if symptoms persist/alter or are particularly troublesome. An acute anal fissure is a tear in the skin of the anal canal, and may be treated with dietary advice and a bulking agent. Topical glyceryl trinitrate (GTN) 0.4% ointment should be considered for chronic

2018 Association of Coloproctology of Great Britain and Ireland

10. Perianal versus endoanal application of glyceryl trinitrate 0.4% ointment in the treatment of chronic anal fissure: results of a randomized controlled trial. Is this the solution to the headaches? (Abstract)

Perianal versus endoanal application of glyceryl trinitrate 0.4% ointment in the treatment of chronic anal fissure: results of a randomized controlled trial. Is this the solution to the headaches? Application of nitroglycerin (glyceryl trinitrate) ointment with perianal administration is a widely used treatment for chronic anal fissure. However, headache occurs after application in 20% to 70% patients and leads to withdrawal in 10% of patients.The aim of the study was to investigate whether (...) , Alicante, Spain.Patients were randomly assigned to receive perianal (n = 26) or endoanal (n = 26) administration of 0.4% nitroglycerin ointment (375 mg of ointment containing 1.5 mg of glyceryl trinitrate), applied every 12 hours over an 8-week period.The primary endpoint of the study was the number of patients with headache within 3 hours after application of the ointment, analyzed with the intention-to-treat principle. Intensity of headache pain was rated on a 10-point visual analog scale. Secondary

2012 Diseases of the colon and rectum Controlled trial quality: predicted high

11. Efficacy of egg yolk and nitroglycerin ointment as treatments for acute anal fissures: A randomized clinical trial study. (Full text)

. For the second group, one egg yolk once a day was administered rectally up to 10 days. The pain and bleeding severity were recorded every two days up to 10 days after finishing the treatment course, based on visual scale.The results showed that egg yolk caused a significant reduction in pain and bleeding compared with nitroglycerin (p<0.05). At the beginning of the study, the difference in pain intensity between the two groups was not statistically significant (p-value = 0.25). However, it became significant (...) Efficacy of egg yolk and nitroglycerin ointment as treatments for acute anal fissures: A randomized clinical trial study. Acute anal fissure as a common disease in society has several etiologies and manifestations such as severe anal pain and bleeding. Nitroglycerin ointment 0.2% is the most common topical treatment used. The most common side effect of nitroglycerin is headache, which is annoying for patients and often leads to discontinuation of the drug.Comparison of egg yolk as a natural

2016 Electronic physician Controlled trial quality: uncertain PubMed abstract

12. Rectal Nitroglycerin

Aka: Rectal Nitroglycerin , Glyceryl Trinitrate , Rectiv From Related Chapters II. Indications III. Preparations Glyceryl Trinitrate ointment 0.2% to 0.4% (Compounded by pharmacies) Nitroglcycerin ointment 0.4% (Rectiv) IV. Dosing Apply twice daily for 6 weeks V. Mechanism Chemical sphincterotomy Reduces maximal anal resting pressure VI. Adverse effects Severe (25%) Apply with glove or finger cot to prevent absorption Start at 25-50% of typical dose and advance VII. Drug Interactions s (e.g (...) . ) Contraindicated in combination VIII. Efficacy Study of 80 patients over 8 weeks Fissures healed in 68% using glyceryl ointment Adverse effects: Only 8% healed with standard delivery IX. References (2012) Presc Lett 19(1): 3 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Rectal Nitroglycerin." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Cost: Medications

2015 FP Notebook

13. Commissioning guide for rectal bleeding

if symptoms persist/alter or are particularly troublesome. An acute anal fissure is a tear in the skin of the anal canal, and may be treated with dietary advice and a bulking agent. Topical glyceryl trinitrate (GTN) 0.4% ointment should be considered for chronic fissures (duration of symptoms >6 weeks or clinical appearances of chronicity) with appropriate advice about application and duration of treatment. 12 Low risk patients with rectal bleeding who are concerned about colorectal malignancy should (...) by linking a proportion of income to the achievement of local quality improvement goals CT colonography medical imaging procedure using x-rays and computers to produce images of the colon and Commissioning guide 2013 Rectal Bleeding 3 rectum digital rectal examination (DRE) medical examination of the back passage with a finger diverticular disease pockets in the bowel from weakness of the muscle layers in the bowel wall faecal calprotectin stool test for inflammatory bowel disease faecal occult blood

2014 Association of Coloproctology of Great Britain and Ireland

14. Stability of Hydrocortisone, Nifedipine, and Nitroglycerine Compounded Preparations for the Treatment of Anorectal Conditions (Full text)

Stability of Hydrocortisone, Nifedipine, and Nitroglycerine Compounded Preparations for the Treatment of Anorectal Conditions 27621496 2016 09 13 2018 11 13 1920-2903 69 4 2016 Jul-Aug The Canadian journal of hospital pharmacy Can J Hosp Pharm Stability of Hydrocortisone, Nifedipine, and Nitroglycerine Compounded Preparations for the Treatment of Anorectal Conditions. 329-33 Friciu Mihaela M Faculty of Pharmacy Université de Montréal Montréal, Quebec. Chefson Amandine A Faculty of Pharmacy (...) Université de Montréal Montréal, Quebec. Leclair Grégoire G Faculty of Pharmacy Université de Montréal Montréal, Quebec. eng Journal Article 2016 08 31 Canada Can J Hosp Pharm 0215645 0008-4123 2016 9 14 6 0 2016 9 14 6 0 2016 9 14 6 1 ppublish 27621496 PMC5008432 Br J Surg. 1996 Jun;83(6):771-5 8696736 Lancet. 1997 Jan 4;349(9044):11-4 8988115 Med Sci Monit. 2003 Oct;9(10):PI123-6 14523338 World J Gastroenterol. 2006 Oct 14;12(38):6203-6 17036396 Dis Colon Rectum. 2000 Oct;43(10):1359-62 11052511 Dis

2016 The Canadian journal of hospital pharmacy PubMed abstract

15. Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure. (Full text)

had pain with constipation, whereas 31 (51.7%) patients had bleeding per rectum. Upon clinically examining the anal area, tenderness was elicited in all 60 (100%) patients. Group A included 30 (11 females and 19 males) cases treated with topical 0.2% nitroglycerin ointment and Group B included 30 (11 females and 19 males) cases who underwent open partial lateral anal sphincterotomy. In Group A, only 15 patients with fissures were successfully treated (50%). By contrast, 28 (93%) patients (...) Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure. Anal fissure is a common benign condition. An anorectal problem is defined as a split in the anal canal mucosa that extends from the dentate line to the anal verge. Chronic anal fissure is defined by a history of symptoms present for more than 2 months' duration and with a triad of external skin tags, namely, a hypertrophied anal papilla, an ulcer with rolled edges, and a base exposing the internal sphincter

2014 Asian journal of surgery / Asian Surgical Association Controlled trial quality: uncertain PubMed abstract

16. Comparison of the efficacy and safety of topical diltiazem and nitroglycerine for pain relief during transrectal ultrasound guided biopsy of the prostate. (Abstract)

Comparison of the efficacy and safety of topical diltiazem and nitroglycerine for pain relief during transrectal ultrasound guided biopsy of the prostate. Transrectal ultrasound biopsy of prostate is a painful procedure. The introduction of the rectal probe is one of the major contributors to the pain associated with this procedure. Drugs that relax the anal sphincter should theoretically decrease this pain. This study was done to compare the efficacy and safety of two topical medications (...) that relax the anal sphincter, diltiazem and nitroglycerine, in decreasing the pain associated with transrectal ultrasound guided prostate biopsy.66 patients who were to undergo their first prostate biopsy were randomized to receive either 2 mL of 2 % topical diltiazem or 2 mL of 0.2 % topical nitroglycerine or placebo 20 minutes before prostate biopsy. All patients also received 15 mL of intrarectal lignocaine. A 10-point visual analogue score was used to record the pain immediately after the insertion

2012 International braz j urol : official journal of the Brazilian Society of Urology Controlled trial quality: uncertain

17. Dose Escalation Trial of Nitroglycerin, 5-flourouracil and Rad Therapy for Rectal Cancer

Dose Escalation Trial of Nitroglycerin, 5-flourouracil and Rad Therapy for Rectal Cancer Dose Escalation Trial of Nitroglycerin, 5-flourouracil and Rad Therapy for Rectal Cancer - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Dose Escalation Trial of Nitroglycerin, 5-flourouracil and Rad Therapy for Rectal Cancer The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01407107 Recruitment Status : Unknown Verified May 2016 by University of Texas Southwestern Medical Center. Recruitment status was: Active

2011 Clinical Trials

18. Topical Application of GTN 0.4% in the Treatment of Anismus Following Stapled Haemorrhoidopexy

Resource links provided by the National Library of Medicine available for: Arms and Interventions Go to Arm Intervention/treatment Experimental: GTN In this arm the investigators administer local application of 0.4% nitroglycerin ointment and ketorolac tromethamine 10 mg Drug: 0.4% nitroglycerin ointment Local endoanal application 2 times a day Other Name: Rectogesic Active Comparator: Control In this arm the investigators administer local application of lidocaine cloridrato 2.5% and ketorolac (...) Topical Application of GTN 0.4% in the Treatment of Anismus Following Stapled Haemorrhoidopexy Topical Application of GTN 0.4% in the Treatment of Anismus Following Stapled Haemorrhoidopexy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one

2011 Clinical Trials

20. ERCP-related adverse events

An updated meta-analysis (11 RCTs, 2095 patients) showed thatglyceryltrinitratereducestheoverallincidenceofPEP(RR 0.67, 95%CI 0.52–0.87) but not that of moderate to severe PEP.Subgroupanalysesrevealedthat sublingualadministration (2–5mg before ERCP) was superior to transdermal and topical RECOMMENDATION ESGE suggests administration of 5mg sublingual glyceryl trinitrate before ERCP in patients with a contraindication to NSAIDs or to aggressive hydration for the prevention of PEP. Weak recommendation (...) ,repeatedinadvertentmainpancreaticduct(MPD)cannulation.NSAIDs,nonsteroidalanti-inflammatorydrugs. Dumonceau Jean-Marc et al. ERCP-relatedadverse events: ESGEClinical Guideline… Endoscopy GuidelinePre-ERCP and post-ERCP administrations of NSAIDs were compared in a single head-to-head study [94]; 2600 patients were randomly allocated to receive rectal indomethacin either beforeERCProutinelyorafterERCPselectively,i.e.,iftheywere athighriskforPEP.Inthesubgroupof586patientswhowereat high risk (all patients therefore received rectal

2020 European Society of Gastrointestinal Endoscopy

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