nifedipin for newly diagnosed chronic fissure

nifedipin for newly diagnosed chronic fissure

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nifedipin for newly diagnosed chronic fissure

Postby eklmaria » 27 Apr 2020, 15:32

Hello-
I am a 23 yr old female.
I stated having bleeding 6 weeks ago with pain during bowel movements.
I went to see a specialist two weeks ago and he gave me hydrocortisone. I tried it for a week but didn't feel it helped so I stopped.
My symptoms were pretty mild most of this time but two days ago the burning and aching became severe.
I saw my specialist again today and he said to try nifedipine 0.3 and if it doesn't heal in 3 weeks, I should do surgery.
I am going to start the nifedipine tonight, and along with that I have been eating more fiber, doing sitz baths, and icing.
Do you guys have any more recommendations? I really don't want to do surgery and am hoping i heal.

Thanks,
eklmaria
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Re: nifedipin for newly diagnosed chronic fissure

Postby patience_and_healing » 27 Apr 2020, 22:22

Hi there, sorry you are having to deal with this. What kind of specialist did you see? Was it a colorectal specialist or a gastroenterologist?

Nifedipine is usually prescribed for 6 weeks. Your fissure is not chronic yet, so I'm surprised that the doctor is willing to suggest surgery already. Couple that with the fact that hydrocortisone was prescribed when it does nothing for healing and thins out the tissues. I would proceed cautiously and get a second opinion from a colorectal specialist. Do not let them do a digital exam with an active fissure. That is both unnecessary and traumatic. Most fissures are visible by external exam.

Avoid eating too much insoluble fiber. That makes BMs bulky and delays healing. Stick to gentle softeners like Miralax. Icing is good for pain relief but increasing blood flow with warm sitz baths can help with healing.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
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Re: nifedipin for newly diagnosed chronic fissure

Postby eklmaria » 27 Apr 2020, 22:55

Thanks for the reply!
I saw a colon and rectal specialist.
He said it was chronic because at 4 weeks my pain was mild, but now at 6 weeks, there is no visible healing and my pain is worse. My main symptom is an intense burning sensation.
Yeah I was shocked that he recommended surgery and I’m going to wait until I’ve been on the medicine for a few weeks, then get a second opinion.
My stool is already soft, so I am not planning on taking a softener.
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Re: nifedipin for newly diagnosed chronic fissure

Postby dmcff » 28 Apr 2020, 06:35

Re surgery: it's not clear what surgery your CRS recommended. Some people have been helped by lateral internal sphincterotomy (LIS). But it's your choice, and you shouldn't feel under any pressure to undergo that procedure. Others have found that physical therapy (PT) helped to reduce the pain. My own solution was to take an anti-convulsant, pregabalin, which has helped me a lot, though it hasn't removed the pain entirely. Am just pointing out that there are a number of different approaches to this condition.
2014 Anal fissure
2015 CAT scan, EUA and sigmoidoscopy, 2 MRI scans - 4 hospital stays - severe to low pain
2016 Anal fissure - pain severe then moderate to low
2017 Return of moderate pain
2018 Physiotherapy, pain management
2019-20 Just living with it
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Re: nifedipin for newly diagnosed chronic fissure

Postby hurtinend » 28 Apr 2020, 11:16

Just FYI I tried hydrocortisone and it didn’t help.
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