I have recurring fissure from past 13 months right after birth of my baby.
I am using magnesium powder everyday. And use nifedipine + Sitz bath for flare ups. No constipation issue. Sometimes BM is not soft enough and it reopens the fissure. I also noticed I have urgency in morning due to magnesium powder I take in night. I m taking one tea spoon. I have virtual appointment with gastroenterologist in July. Initially they booked me for colonoscopy which I don’t want to do as I find it very invasive.
So i will ask the gastroenterologist if I need to take another stool softener or laxative so fissure heals. Any suggestion is highly appreciated.

I would use something more easy to titrate like Miralax. Also try the nifedipine on a regular basis not just for flares. Use it 20-30 minutes before the first BM to allow for the muscles to relax. A gastroenterologist isn't the best specialist for fissure treatment, you could consult a colorectal specialist instead.

patience_and_healing wrote:I would use something more easy to titrate like Miralax. Also try the nifedipine on a regular basis not just for flares. Use it 20-30 minutes before the first BM to allow for the muscles to relax. A gastroenterologist isn't the best specialist for fissure treatment, you could consult a colorectal specialist instead.

Thank you for your feedback. My physician told me to use nifedipine only on flare ups so I was using it for 4-5 days until I hav pain with BM. Also she referred me to gastroenterologist. I m not sure if I can ask her to refer me to colorectal specialist without offending her. Here in Canada specialist appointments are based on referrals only.
Is mag citrate powder not good for soft BM??? How long I can use nifedipine without any side effects.

Magnesium citrate is probably fine but I prefer not to take something that may cause electrolyte imbalances. As for the nifedipine, it could be ok to use long term, but you need to confirm that with your doctor.

I'm no doctor but nefedipine needs to be applied 2-3 times per day for up to 6 weeks to be effective. I don't see how it can help with flareups. At 13 months you should see a colateral specialist.

Thanks for your response. I just had phone call with gastroenterologist. He also said that nifedipine should be applied for longer time. But he wants to do Sigmoidoscopy to confirm if it’s fissure before giving any recommendations on duration how long I can apply nifedipine. Please suggest what options I have?

1. Shall I go for Sigmoidoscopy? Is it going to help with anything? I am scared of re tear.
2. Shall I start using nifedipine for 6 weeks and see if my fissure heals for good? Any side effects? If it does not heal, go for step 1.
3. Shall I ask my doctor to refer me to a colorectal specialist? What reasoning should be given?

I am feeling better since last 3 weeks almost. I have been applying forces of nature fissure control oil from 3 weeks. And taking magnesium citrate at bed time.

Thank you.

I can't answer question 1, but you should be taking nefedapine twice per day. I've been on it for 3 weeks with no side effects. I know others who've taken it daily upwards of 6 months with no problems.

I would definitely ask for a referral to a CS. The CS is the only one that can perform the LIS surgery should you choose to go that route. I have my appt. with the CS next week to discuss surgery.

Dust 2 Dust wrote:I can't answer question 1, but you should be taking nefedapine twice per day. I've been on it for 3 weeks with no side effects. I know others who've taken it daily upwards of 6 months with no problems.

I would definitely ask for a referral to a CS. The CS is the only one that can perform the LIS surgery should you choose to go that route. I have my appt. with the CS next week to discuss surgery.

Thank you for your response. Do you feel any better while using nifedipine for 3 weeks?

A little bit. I don't spasm as much, but I've been suffering for 4 months and I want to get the surgery and be done with it all. Pain wise I have good and bad days.

Dust 2 Dust wrote:A little bit. I don't spasm as much, but I've been suffering for 4 months and I want to get the surgery and be done with it all. Pain wise I have good and bad days.

That’s good that you feel little better.
I have this problem started 13 months ago. I am having re tear every 2-3 weeks . I apply nifedipine for 2-3 days when it tears and i feel better . I had two blissful 6 weeks with out pain in last 13 months. I thought it healed but then it tore again. It just so overwhelming taking care of this fissure