Kim wrote:The first thread on this board (General Anal Fissure Discussion) entitled Sticky:I have an AF -- what should I know?
Thanks!

Hey Kim, I wasn't entirely sure which of my posts you wanted me to add to the sticky thread, so I went ahead and just wrote up a summary of my experiences thus far in that thread. It's a bit of a novel, but hopefully it's along the lines of what you were interested in -- if it isn't, let me know, and I'll correct it ASAP.

Hey - I used both : ) !!! I alternated both creams during the day . Applied Nitro 3 times and Nef, 2 times. At one point I got Nitro 0.4 % !!! Than there were days I used one only - I tried it all - mix and match and stuff ... My fissure healed but result was short lasting and I had a LIS as soon as I ripped open again !!!
Best of luck !!!
PS: If you mix nitro and nef. together and apply - you dilute concentration of Nitro - so you have less headache, but also less effect !!!! I would rather you use a single cream alternately if you decide to use both kinds, and not applying both at once.

Hey Fissulyna,
Thanks, I've been trying them on alternate days with mixed results so far. I have three ointments, one is just 0.2% nitroglycerin, another is just 0.2% nifedipine, and the third is 0.2% nitroglycerin / 2.0% hydrocortisone / 5% lidocaine.
I rarely use the third one unless the anal area feels swollen or my hemorrhoids feel like they might be acting up too. The other two I swap between every day or two; I never use both ointments on the same day (no real reason for this though other than an outside chance of hypotension). For the fissure, I was using nitro for a few weeks and only got marginal benefits from it, so I changed to nifedipine to see if that made any difference. Right now it seems that I'm getting the most mileage out of switching between the two every few days. I've been using nitro for a while so I don't really notice the headaches anymore.
I don't know if any of this is actually healing the fissure, but it's providing some symptomatic relief. I have a CRS appointment next week where I'm hoping the doc can have a peek and let me know if she sees any signs of progress.

NG I've been using them together for months and the surgeon and GP know about it so go for it, ot doing much for me but might help you xxxxxxxxxxxx
I use the nitro during the day, mine is 2% aswell ! and the other at night and morning, we call it diltiazen over here xxxx

Nice, thanks Peachy! You mean 0.2% for the nitro right? Just checking because 2% seems like pretty strong stuff for fissures...
I notice for sure that both loosen the sphincter up a bit before a BM, allowing the stool to come out easier, but who knows if it actually promotes long term healing. I've been in less pain since alternating between nitro and nifedipine, so I guess that's a good thing, but I can never be too confident when it comes to this stinkin' fissure. It seems like I'm always one bad BM away from being back at square one!

Hey NG no I did mean 2% there have been a few queries from chemist but doc says as I've been using it for 3 months it will be fine ! Lol xxxx

Peachy724 wrote:Hey NG no I did mean 2% there have been a few queries from chemist but doc says as I've been using it for 3 months it will be fine ! Lol xxxx

Wow dang you've really brought out the big guns to fight that fissure already! I've actually been meaning to ask my CRS next week about upping my nitro concentration to 0.4%. I barely get any side effects from the 0.2% anymore so I wonder if a higher concentration would do me some good.
If you've been on 2% nitro for months and it's done nothing, then maybe your fissure really is bad enough where the Valium won't do any good. Sheesh, here I thought I had it bad, but it sounds your case is a lot more severe.

I think the valium might still help, it is certainly worth a try. It won't be a cure-all, but any relief is welcome relief!

Kim wrote:It won't be a cure-all, but any relief is welcome relief!

Kim, I think this line right here sums up the thoughts of fissure sufferers everywhere! In fact given my penchant for tattoos, maybe I will make this my next one. I'll proudly display it, its meaning remaining a mystery to all but a select few :)

Ha Ha i have a fair few tattoos myself and was wanting another one, its a thought!! lol
I wouldn t know if my fissure is worse, i think any one must be a nightmare at the least. Ive had it for 6 months and my immune system is shot to peices, i have done damage to my boy through years of starving myself so maybe thats why im not healing. I think the Valium is working a little at least, the pain is now just a dull annoyance and i have been able to clean the bathroom and sort my kitchen out but i think i have pushed it a little as im getting sore again. I was wanting to have a few glasses of wine tomorrow, if i refrain from taking the tramadol and valium tomorrow just for the day will it will be okay to indulge?
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