Anal fissures and haemorrhoids Flashcards
(11 cards)
How does glyceryl trinitraterectal ointment work?
Mechanism: Glyceryl nitrate is converted in the body to nitric oxide (NO), a potent vasodilator.
Effect: Nitric oxide relaxes smooth muscle cells in blood vessel walls, causing them to widen (dilate).
Application in Rectal Ointment: When applied as a rectal ointment, it mainly acts on the smooth muscle of the anal sphincter and local blood vessels.
Result: This relaxation reduces anal sphincter pressure and improves blood flow in the area.
What is an anal fissure?
A tear or ulcer in the lining of the anal canal, immediately within the anal margin.
What is the primary focus in the initial management of acute anal fissures?
Ensuring stools are soft and easily passed - bulk forming first line.
What topical treatments can be used short-term for burning pain after defecation in acute anal fissure?
Local anaesthetics (e.g., lidocaine hydrochloride) or simple analgesics (paracetamol or ibuprofen).
Which drug is commonly used topically to treat chronic anal fissure?
Glyceryl trinitrate (nitroglycerin) rectal ointment 0.2% or 0.4%.
What is a common side effect of glyceryl trinitrate ointment in treating chronic anal fissures?
Headache (in about 20-30% of patients).
What are haemorrhoids?
Abnormal swellings of the vascular mucosal anal cushions around the anus.
What non-drug advice helps in managing haemorrhoids?
Keeping stools soft by increasing dietary fibre and fluid intake, and practicing good perianal hygiene.
What type of laxative is preferred if constipation is present in haemorrhoid patients?
Bulk-forming laxatives.
Which analgesics should be avoided in haemorrhoids if there is rectal bleeding?
NSAIDs.
Are topical haemorrhoid preparations licensed for use during pregnancy?
No, but soothing preparations without local anaesthetics or corticosteroids can be considered.
