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Previous Volume 333:1156-1157 October 26, 1995 Number 17 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Myenteric nerves innervating the internal sphincter muscle of the anus produce and release nitric oxide,^1,2 the chemical messenger that mediates relaxation of this muscle.¹ A derangement in nitric oxide regulation may underlie the anal-sphincter hypertonicity associated with anal fissures and ulcers. Nitroglycerin, which is locally metabolized to nitric oxide, lowers the mean resting pressure of the anal sphincter when applied topically to the anus.³ A pilot study of 15 patients showed that topical nitroglycerin was useful in treating anal fissures and ulcers.⁴

Forty patients with anal fissures (26 women and 14 men; mean age, 38 years) and . . . [Full Text of this Article]

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