Notes for: Local Prepn for Anal & Rectal DisordersLast edited [09/08/2011 08:45:43]
1. These preparations are of limited clinical value and should only be used for short periods (not more than a few days) as they cause sensitisation of the skin. Excessive application of preparations containing local anaesthetics should be avoided.
2. Glyceryl trinitrate ointment 0.2 - 0.3% or 0.4% is included for the treatment of anal fissures. It produces what is in effect a temporary reversible chemical sphincterotomy which causes a relaxation in the anal sphincter and is thought to encourage healing of acute anal fissures by improving the blood supply to the perianal skin. The 0.2 - 0.3% treatment has to be specially manufactured and care is required to ensure that, for example, 0.2% ointment is prescribed rather than the commercially available 2% preparation. The ointment is usually applied twice a day with treatment continued for 6 weeks. It is often useful in the initial stages of treatment to combine glyceryl trinitrate ointment 0.2 - 0.3% with a local anaesthetic / steroid preparation eg Scheriproct.