Hello All,

I was put on Dilitiazem by the good doc. When applied I experienced a warm feeling in the area. Three days latter my sentinel pile was all flared up and its been a week now.

I was wondering if dilitiazem could have caused the flare up. Has anyone else experienced this. Can someone shed some light.

Thank you.

Hi XTY, I do believe that diltiazem can be very irritating to the skin. Many on here have had trouble with it, including myself. It's a wonder that Doctor's prescribe it all IMO when nifedipine seems so much less irritating and equally effective. Did you stop using it?

Hello msimon.

I did stop. Then a friend shared his experience of healing with dilitiazem. So I have been ON for three days now. So far so good. Fingers, toes and eyes crossed :).

Will update.

I really hope it works for you. Some people do develop a sensitivity after using that ointment for a while as well so keep in mind you could always try one of the others if need be (nifedipine or nitroglycerine).

Thank you msimon. You mentioned two meds. Do they have any side effects. I do notice that my sentinal pile is noticibly irritated by the D..zem. I am staying away from D..Zem.

I am prone to headaches. Please share your thoughts.

I like the nifedipine as it is less likely to cause headaches and nitroglycerin did irritate my skin sometimes. I think it (nifedipine) does give me a racing heart at times and it has been known to cause lightheadedness but that never happened to me. Everyone is different though. Would be something to try...

Nitro commonly causes headaches but I am fine at the 0.2%. I like that it seems to kick in the fastest.

Using D..zem has irritated my sentinal pile to no end. I am honestly too scared to apply anything there while the SP is still irritated.

Just read of a study where nephadamine 20 mg twice daily was given orally for 8 weeks.

But that has been just one study.

Diltiazem gave me the worst rash I've ever had in my life. I think it's quite rare to have such a reaction, but many people find it irritating. I would stop using it. The irritation is likely to get worse not better.
I used nifedipine at first and found it totally ineffective - but that's just me.
Diltiazem was effective, but obviously I had to stop using it.
Nitroglycerine has been effective for me. I get a slight feeling of fullness in the head and throat about 5-10 minutes after applying it, and sometimes my head throbs for a few seconds. It's a small price to pay.
Others get bad headaches and can't tolerate it. If you try nitroglycerine, I recommend starting with tiny amounts, the size of a lentil, and work up to a blob the size of a pea over several days. That may help you get accustomed to using it without headaches.

good luck!

Thank you.

I don't know where you are located Xyz but here in Canada I use a cream called Penanten:

http://www.penaten.ca/en/baby/penaten-o ... en%20cream

It is a diaper cream that is mostly zinc and has done wonders for me for skin irritation down there. I'm assuming you are in the US? There must be something like that there. I have also used pure vitamin e oil and pure alone vera at times to settle things down. The zinc cream is great though as it is very chalky and stays on and coats things for quite some time. I really think it accelerates healing as well.

Oral medications for anal fissures have not been shown to be as effective and have more side effects so topical is generally best. Hope you feel better soon.