It's getting better. It still hurts a lot if the BM is formed (even if it's soft) at all. It seems like a winning formula is to apply the diltiazem around an hour or two before the first BM of the day. It may hurt during the BM and for a short while after but it doesn't hurt half an hour later. However, it does hurt a bit (not close to the pain during the first week but it's uncomfortable) if I don't manage to out the cream on in time. We drove over 2,000 miles the last week and it's mostly been fine. I've had a couple of days when I was uncomfortable but it's at last tolerable now.

It's been just over three weeks since the fissure re-appeared after a three year absence and it's evident that it's still got a long way to go until it's healed. It seems like it's getting better and I'm happy with that.

Are your BMs too soft or too firm or do they vary? I still have at least three BMs a day but I always had. I'm guessing one per day would be better as it would allow the fissure more time to heal between BMs.

Does she think you'll heal if you continue to use the nifedipine ointment?

I think my case is somewhat similar to yours. I do experience pain during BM due to an internal fissure which gives me a glass cut kind of feeling during the initial time of bowel, and then I am able to pass the BM fine (no blood in stools). There is no pain during the remainder of the day, only during the initial BM passing phase. I visited the CRS, and initially he prescribed me the hydrocortizone cream,which I was applying for a few days. During my last visit, he prescribed me the nephedipine ointment and mentioned it would relax the muscles and help me get rid of that initial glass-cut sensation during BM. I have been applying the nephedipine gel topically (on the outside) since a couple of days in addition to coconut oil, but not seeing any changes as such (not sure if this really heals the internal fissure as I am currently applying it on the outside and not really deep inside). may be it would take some more time to take effect. also I have heard of the h-fissures oil and have ordered it online. has this oil worked for anyone & since it's homeopathic can it be applied in conjunction with the nephedipine ?

I have heard a lot of cases wherein the LIS has really not cured the anal fissure (LIS being almost equivalent to what the nephadipine does, i.e. enlarging and relaxing the muscle spasm and not really healing the internal anal fissure itself)..

appreciate if you/others can share views/thoughts.

She thinks I may heal, but it might retear in the future since the muscle will still be tight. I'm hoping that dilation will prevent that though.

I'm having trouble keeping the BMs firm enough. Soft BMs are terrible for me, and cause a lot of irritation. I'm​ keeping a diet diary and trying to figure out the cause. So far I've narrowed it down to wheat and take out Asian food.

Good to hear you are getting better. I hope your fissure heals up soon.

@sunshine- I have no experience with h fissure. In general I steer clear of things touted as 'miracle cures' because I feel they prey on desperate people. Nifedipine is a very good ointment and I think it will bring blood flow to the area even if not applied directly to the fissure. You don't want to irritate the fissure 3 times a day while applying ointment. Hydrocortisone is no good because it thins out the skin and delays healing.

thanks very much for the response. I will definitely keep on applying the Lido 3% Nifedipine 0.5% gel prescribed by the CRS (currently been applying it topically 2-3 times a day since last Sun). I have already stopped applying hydrocortizone. Keeping the h-fissures oil as a last option, though I still haven't received their shipment. I will continue for a month or so with the nifedipine. Any idea the timeframe by which I would have seen any improvement ? so far it's still been the same, i.e. pain while passing the initial stool which continues for a few more hours and then totally fine at evening/night.. no blood in the stools..any other things I should be trying ? I do take the Senna-S laxative at night (2 caplets) to ensure a softer BM and have also been taking Metamucil. Really feel depressed as not able to concentrate on my job in the first half in the morning..

Depression and fissures go together I feel. I too have hit my lowest point several times since I got a fissure. You haven't been applying the ointment for too long. Hopefully you should start feeling better in another week or two. If no improvement, then you can ask your doctor for a different ointment.

Thank you very much for giving me the hope. That really makes me feel better. I have been using coconut oil as well to massage the area and applying the nephadipine cream as mentioned 2-3 times each day. Hoping and praying to god that I don't have to go through the LIS surgery, very very scared..Each morning the time before going for a BM makes me fear. One question I have though, should I be applying the nephadipine cream early morning once I wake up & before going for a BM.. will that make a difference and relieve the initial stretch/tear/pain that I experience during the BM. appreciate if you can give me some feedback on this.. thanks again.

I can totally understand the fear before a BM. When I go each morning, I think of pleasant things because stressful thoughts make muscles tighten up. I also apply nifedipine 10-15 minutes before my morning BM to loosen up things a little. I also apply a coat of a coconut oil Vaseline type gel, in order to protect the fissure. I'm still not sure if this helps, but I've gotten into the habit of doing it so I continue. After BM, I wash, take a sitz bath, shower, dry my backside thoroughly with a hair dryer and reapply nifedipine. The second CRS I visited said to use the 0.3% 4 times a day so that's what I'm doing now.

i totally agree with the bm fear.!

Thank you very much again for the feedback. I will follow the same step of applying the niphedipine and coconut oil combination before 10-15 minutes of BM. Also, I have taken the Senna-S laxative (2 tabs yesterday and 2 tabs today morning), so hoping today's BM goes fine..