C Connolly1,2, S Tierney3,4, P Grace3,5. 1. Department of General Surgery, Limerick University hospital, Dooradoyle, Limerick, Republic of Ireland. caramconnolly@rcsi.ie. 2. Department of Anatomy, The Royal College of Surgeons in St. Stephens Green, Dublin 2, Ireland. caramconnolly@rcsi.ie. 3. Department of General Surgery, Limerick University hospital, Dooradoyle, Limerick, Republic of Ireland. 4. Vascular Surgery, Tallaght Hospital, Dublin 24, Republic of Ireland. 5. University of Limerick, Limerick, Republic of Ireland.
Abstract
BACKGROUND: Nitric oxide (NO) has diverse roles as a biological messenger. [1] Topically applied nitrate donors cause relaxation of the internal anal sphincter (IAS) and facilitate healing of anal fissures [2,3]. Systemic nitrates are commonly used for the treatment of ischaemic heart disease, yet the effects of systemically administered nitrates on the smooth muscle of the IAS are unknown. AIM: Our aim was to test the hypothesis that systemically administered nitrates at a normal dose, cause inhibition of anal sphincter activity. METHODS: With fully informed consent, anal manometry was performed on nine volunteers. Maximum and mean anal resting pressure (representing the IAS), maximum squeeze pressure (representing the external anal sphincter), heart rate and blood pressure were measured, before and after administration of a normal 400 μg dose of sublingual glyceryl trinitrate spray. RESULTS: Data are expressed as mean (± standard error of the mean (SEM)). In four females and five males ranging from 19 to 50 years of age, administration of GTN resulted in a significant reduction in systolic blood pressure from 138 ± 5 to 127 ± 4 mmHg, P < 0.01. Mean resting pressure, over 5 min, was significantly reduced from 70 ± 10 to 62 ± 10 mmHg P < 0.05. The maximum resting pressure was also significantly reduced from 109 ± 12 to 86 ± 10 mmHg P = 0.04. Maximum squeeze pressure, heart rate and diastolic blood pressure were not significantly reduced. CONCLUSION: Systemic nitrates significantly inhibit internal anal sphincter function.
BACKGROUND:Nitric oxide (NO) has diverse roles as a biological messenger. [1] Topically applied nitrate donors cause relaxation of the internal anal sphincter (IAS) and facilitate healing of anal fissures [2,3]. Systemic nitrates are commonly used for the treatment of ischaemic heart disease, yet the effects of systemically administered nitrates on the smooth muscle of the IAS are unknown. AIM: Our aim was to test the hypothesis that systemically administered nitrates at a normal dose, cause inhibition of anal sphincter activity. METHODS: With fully informed consent, anal manometry was performed on nine volunteers. Maximum and mean anal resting pressure (representing the IAS), maximum squeeze pressure (representing the external anal sphincter), heart rate and blood pressure were measured, before and after administration of a normal 400 μg dose of sublingual glyceryl trinitrate spray. RESULTS: Data are expressed as mean (± standard error of the mean (SEM)). In four females and five males ranging from 19 to 50 years of age, administration of GTN resulted in a significant reduction in systolic blood pressure from 138 ± 5 to 127 ± 4 mmHg, P < 0.01. Mean resting pressure, over 5 min, was significantly reduced from 70 ± 10 to 62 ± 10 mmHg P < 0.05. The maximum resting pressure was also significantly reduced from 109 ± 12 to 86 ± 10 mmHg P = 0.04. Maximum squeeze pressure, heart rate and diastolic blood pressure were not significantly reduced. CONCLUSION: Systemic nitrates significantly inhibit internal anal sphincter function.
Authors: William E Whitehead; Lori Borrud; Patricia S Goode; Susan Meikle; Elizabeth R Mueller; Ashok Tuteja; Alison Weidner; Milena Weinstein; Wen Ye Journal: Gastroenterology Date: 2009-05-04 Impact factor: 22.682
Authors: Otto R Maarsingh; Hanneke Stam; Peter M van de Ven; Natasja M van Schoor; Matthew J Ridd; Johannes C van der Wouden Journal: BMC Geriatr Date: 2014-12-15 Impact factor: 3.921