Dilziatem

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Dilziatem

Postby anthony999 » 14 Jul 2012, 04:38

I am new to this forum and it was a blessing to find it. So much information and support. Thank you.
I was prescribed Dilziatem. Got home and realized I never asked (and Dr. never told me) how to apply it. Any suggestions? I tried putting on finger and pushing a little ways in, but found this uncomfortable (thusly, have been avoiding using it). Do most just slather it on the external anus? How much? Dr. told me to apply it 2 times a day. Is that what others are doing?
Thank you for any suggestions.
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Re: Dilziatem

Postby Ever the Optimist » 14 Jul 2012, 05:45


Hi Anthony,
Sorry to hear you are suffering!
There's been a lot of posts about this one and seems some CRS' are not very good at explaining exactly how to apply the cream. There have been lots of posts discussing this issue but in my experience, the following is the best and the way I was advised to use the cream....This is a posting by another fellow sufferer and I believe offers great advice:
You have to put this cream inside your butt. It will not work on the outside. I have been prescribed this and I was told to use it "Internally".
The reason Diltiazem works is that it stops the sphincter muscles from spasm. The muscle spasm is what delays healing and causes pain and sometimes further injury.
If you use this on the outside, you will be doing NOTHING to stop the sphincter muscles from contracting and pulsating.
The trick is doing this without hurting your fissure. The best way I can tell you is:
Use your pinkie finger, put a generous amount on the tip. Stick it up your butt juuuust enough that it is going inside. Then, simply sit down. I think the act of sitting down spreads out the amount of cream and it will cover all areas (including your affected ones).
This has REALLY helped me. I am getting better all the time (as long as I eat tons of fiber and drink a lot of water). Using this externally would not have helped..
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My response to this was:
Have to TOTALLY agree with the above post....
Exactly how I was also advised to use the cream and for the same reasons given...
It also did a fantastic job on helping with the fissure.
I applied the cream internally twice daily, once in the morning, after a bath and post BM and once in the evening after a bath before bed. You need a good pea sized amount and it needs to go inside. Perhaps, you could find a syringe or something similar to help insert the cream if you find it painful using your finger???
Truly helping it helps you!
All the very best in your healing process :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Dilziatem

Postby anthony999 » 14 Jul 2012, 12:35

Ever the Optimist,
Thank you for the reply and reposting this information. It confirms what I need to be doing and gives me hope.
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Re: Dilziatem

Postby dan2012 » 14 Jul 2012, 13:47

Let me throw my 2 cents here. My CRS, who's a true expert and works in a very reputable hospital system, said expressely to NOT apply inside. Actually, I had been applying inside for 3 weeks prior to visiting her, and I hurt myself several times (including the fissure spot). In the last few days, I've been using a Q-tip to apply right around the anal entrance, but NOT inserting it. At least with me, I found the results of this method much superior.
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Re: Dilziatem

Postby AFpaininthebutt » 17 Jul 2012, 20:11

Here is a link with another person's opinion.
http://www.boardsailor.com/jack/af/patient_21.htm
I'm not claiming that I'm a "true expert", but how can you possibly heal when you are not using the cream correctly.
NOT using the cream internally is like having a cut on your hand and putting a band-aid on your foot.
If you're healing, its because of placebo, good diet, lots of water and thanking God.
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Re: Dilziatem

Postby dan2012 » 17 Jul 2012, 20:50

Something interesting happened today. I'm switching to Nifedipine because of some side effects of Diltiazem. So my wife went to the pharmacy to pick the Nifidipine up and the pharmacist told her twice:
"You need to pay attention to one thing... This is for external use only. Don't apply it inside".
So it's another divergent opinion. I'm not a doctor, so my personal opinion counts little.
However, I don't agree nyour hand/foot analogy. This medicine gets absorbed by the anal skin and goes into the bloodstream - if that wasn't the case, nobody would have headaches from nitro. The internal sphincter is extremely close to the outside of the anus and thus the medicine would have a high concentration in the bloodstream near the internal sphincter area. The reason the doctor stated for not using it inside is that you can hurt the fissure by attempting to do so - and guess what, I had exactly done that in the previous day.
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Re: Dilziatem

Postby AFalumni » 17 Jul 2012, 21:56

Try calling your CRS - I'm sure he/she will guide you (or at least have a nurse to give you further instructions. My CRS said to use a glove, put a pea size amount on the tip of my pinkie, and insert it just to the first knuckle or so. Just the tip.
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Re: Dilziatem

Postby powderblue » 10 Jan 2014, 14:16

Interesting, two completely different approaches... which one is correct?
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Re: Dilziatem

Postby JHH » 10 Jan 2014, 14:42

AFalumni wrote:My CRS said to use a glove, put a pea size amount on the tip of my pinkie, and insert it just to the first knuckle or so. Just the tip.


This is the way to do it :D
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Dilziatem

Postby powderblue » 10 Jan 2014, 14:49

JHH wrote:
AFalumni wrote:My CRS said to use a glove, put a pea size amount on the tip of my pinkie, and insert it just to the first knuckle or so. Just the tip.


This is the way to do it :D


And going deeper is not advised? I seem to have understood from my CRS that you want to go as deep as possible.
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