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Postby BigRW » 23 Jul 2019, 11:16

Hi guys. My brief story.

Growing up every few years i would have a small swelling around my bum for a few weeks. Never painful always went away.

Fast forward to about 30 years old. Had some sort of swelling that became infected. Eventually told was personal haematoma that had become infected. Cured with antibiotics. Happened every few years. Each time anti biotics and then burst and pain went. In the midst of this I had one fissure (felt like passing glass). And went on lactulose and then fybogel for years.

Surgeon assumed abscess/infected haematoma was coming from a fistula but could never find one (albeit never has operation to check) and hasn’t come back for over 4 years.

Nope I seem to randomly get fissures 1/2 times per year. Horrendous burning and spasm. Valium helps. Very little else seems to. GTN gives me bad headaches. Have asked for diltiazem.

Doctor suggested topical lidocaine for the burning. What do people think?

What else can I do to get the spasms down?

I eat pretty healthy and do exercise. Sometimes fissure comes from diarrhoea sometimes from harder stool. Really can’t predict it. Any thoughts?

Really annoying thing is that I get quite anxious and get urgency and think I need the loo a lot which makes work hard. Very rarely do I actually need to go.

Should I bite the bullet and have Botox?


Thanks so much.
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Re: Hi

Postby Abu » 23 Jul 2019, 22:26

Hi Big, there are many ways to attack this issue but it's impossible to tell which ones work for you and which don't, so you need to try to find the right one.
Think of it this way : you need to work on your mind, to calm it down and learn to relax the muscles around the sphincter. Then you need a healthy diet that fits your body. Not all healthy foods are suitable for everyone, we are all so different... What exactly do you eat regularly?
Then you need to exercise and improve overall health.
And last but not least you need enough sleep to let your body heal and replace the harmed tissue.
Tell us more about you so we can understand where you need to focus the most of your efforts.
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Re: Hi

Postby BigRW » 25 Jul 2019, 11:28

I eat a lot of veg. I try and minimise wheat. I walk a lot every day for work.

Do people think lidocaine cream might help?

What I really need to decide is can I cope with 1/2 times per year of spasms and pain or should I try Botox. GTN have me really bad headaches. Haven’t tried diltiazem yet. Should I do that next ?

Thanks so much
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Re: Hi

Postby Abu » 25 Jul 2019, 12:10

Lidocaine is just a pain relief cream. Do not look at those tools as the ultimate saver as you will be disappointed and can lead to depression when they stop working. Look at ways to control and relax your mind. Your anxiety is influencing the gut flora in a bad way. Also your diet may not suit you if you experience diarrhea and constipation, so look at it too. If you want a cream ask for nifedipine which works on relaxing the sphincter muscle and it does not cause headaches.
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Re: Hi

Postby BigRW » 25 Jul 2019, 12:36

Nifedipine rather than diltiazem? Why? Thank you
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Re: Hi

Postby BigRW » 26 Jul 2019, 16:35

BigRW wrote:Nifedipine rather than diltiazem? Why? Thank you



Any thoughts on this please? I see the doc tomorrow.
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Re: Hi

Postby Abu » 27 Jul 2019, 00:42

Both work the same so why not ask a prescription for both and see which one is better for you?
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Re: Hi

Postby jis76 » 27 Jul 2019, 05:36

Concur with Abu... nifedipine (or diltiazem), relaxes things. Helped me heal many times. Nifedipine was a godsend for me...

The lidocaine I've tried a couple times and actually caused me more pain. According to the nurse I chatted with she said this happens in a small percent of people, while others find it to be very helpful with pain.
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Re: Hi

Postby BigRW » 27 Jul 2019, 17:21

Sorry I’m really new and I’m lots of pain occasionally.

Is nifedipine the same as diltiazem!?
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Re: Hi

Postby jis76 » 27 Jul 2019, 19:01

They are both Calcium Channel Blockers (Nifedipine and Diltiazem) typically used to treat high blood pressure and chest pain. In this case it's mixed in typically with petroleum jelly and applied topically to your anus to help relax the sphincter so your fissure can heal.

Both drugs have similar effect when applied topically. Your Doctor will probably have a preference.

I will say, when I had some issues and started the nifedipine the first time, things started resolving in about 7 days. It was almost like magic!

I would also highly suggest taking Miralax if your stools are hard, this really helped me as well when I was in a lot of pain. Make sure to drink plenty of water...

Don't over wipe. Take lots of baths (especially right after BM).

There are a ton of other tips on the board here. It's often a bit of trial and error to figure out what works best for you.
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