Saw my GP today, turns out I do have an anal fissure. I have for about a month now. Hopefully I got it in time to get it better without any more drastic measures. He gave me two creams. One is Nifedipine, the other Lydocaine. I'm supposed to use them for 6-8 weeks daily & put the Lydocaine on before the Nifedipine. Hopefully those meds, along with trying to add more fiber, will allow me to heal. Going to purchase a sitz bath also. The challenge now, is, can I continue exercising, lifting small weights, etc, can I eat whatever I want as long as I get enough fiber/plenty of water..

Hi Alex, sorry it turned out to be a fissure, but at least you got diagnosed, so - let the healing begin!

Looking into my crystal ball, I see a lot of experimentation in your future, as you figure out what things work for you and what do not.

Diet is crucial. If you are lucky (like me) you won't have to give any foods up, but you will have to stay hydrated. Drink, drink, drink. Water that is; don't take too much caffeine or alcohol, they are diuretic and dehydrate you. Hydration is the key to soft stools. Fibre too - either supplements or food or both. Good fissure-friendly foods are lentils, brown rice, oatmeal and other foods with plenty of soluble fibre.
But if you are unlucky, you'll find that some foods are constipating for you, so you'll have to avoid them.

Your drugs, lidocaine and nifedipine. They are both supposed to be excellent drugs. The lidocaine is a painkiller. The nifedipine is a muscle relaxant. Neither one did anything for me, so here's the important thing - if the nifedipine doesn't work, go back to your doctor and ask for diltiazem. And if that doesn't work, ask for nitroglycerine. What I'm saying is, DON'T GIVE UP. There are other options. I had to try all three, and in the end I healed on nitroglycerine. Everyone reacts differently to drugs, so I'm not saying you'll have the same experience as me, I'm just saying don't be discouraged if it takes time and you have to try more than one cure.

Weight lifting - again, I think you'll have to figure this one out for yourself. Maybe you can lift weights without hurting yourself. Take it very easy with small weights and short workouts and see what you can tolerate. If it hurts, or hurts later the same day, back way off.

Keep a diary of diet and exercise. You can even do it right here on the forum in the diary section. It's really useful to have a record of what you did and how it affected you. You can also record your healing progress, and since progress is sometimes slow with setbacks, it can be good to be reminded that you are in fact getting better.

Good luck! Keep posting here, let us know how you get on. We all know what it's like and we are all rooting for you.

Thanks for the supportive words. How long should I wait after applying the Lidocaine before I put the Nifedipine on? And about how much should I dab/rub on of each per dose? My dosage say twice a day for both. Just wondering if they're meant to be applied one right after the other or to wait between..I put my first Lidocaine on, no biggie, then dabbed some Nifedipine on.

Another thing I wonder is, about how long before the pain with bowel movements should subside? And do these meds help to close the fissure/stop the bleeding too? A few years ago I had a steroid cream for another issue, and it seemed to work well for stopping bleeding.

So I asked the CR nurse some of the same questions you are asking here, and I never really got clear answers. I gave up on the Lidocaine, so I never found the best way to apply it.
For the muscle relaxant (nifedipine in your case) I ended up putting it on after my morning BM and after cleaning up. That way I figured it would be around for several hours. Same in the evening - I put it on last thing at night.
But I know other people apply it before a BM so the anus would be relaxed for the BM, and also to lubricate the anus.
Also, I gave up trying to apply it inside. I know some people do that, but for me I thought putting my finger up inside did more harm than good.

See what I mean about experimenting?

I was told a pea-sized amount of medicine, and that's what I used.

When you ask how long before pain with BMs should subside, do you mean, how many minutes between applying the cream and the spasms subsiding? It didn't really work like that for me. Ibuprofen and sitting on a hot water bottle were the only things that helped the spasms, and even those took at least 1/2 hour to start helping.

But after a couple of days on diltiazem, the pain was diminished and after a few more days I rarely had spasms any more. Pain, soreness, yes, but the terrible spasms didn't seem to kick in any more.

It is really hard to know what to predict. I hope you are lucky and nifedipine works for you immediately. That would be awesome!

The Nifedipine & Lidocaine both say for external use only, so I'm guessing putting them inside the anus is a no-no. I've been using them for just a day now. Not sure yet if they will be any help..How long before I should notice improvement, if they are going to help? A few more days, or more? Less? The Nifedipine is just basically a gel in a bottle with no applicator, so I have to be careful with it. Neither have stung or hurt at all when applying, which is good. I don't think my fissure is too bad, so maybe they caught it in time. I'm hoping it's just a random acute one, that can be fixed and that will be that. Never had one before.

This morning, when going to bathroom, it did seem the anal muscle was a bit more relaxed, and lubricated, because I put the creams on before going. Still had a bit of stinging, hoping that will subside over time.

My primary doctor told me that there was a 90-95% effectiveness rate with this med combo, he seemed highly confident. I sure hope he's right.

You mentioned spasms..I can't say I've noticed any spasms at all, during the past month or so when I've had this so called fissure. Mainly, what I've noticed is just the stinging when stools pass. Maybe that's a form of spasms though.

The Lidocaine is for pain, but the Nifedipine, is it actually to promote the healing of the fissure? About how long does one application last? I did two applications last night, and 2 today, will do one more later.

I have a nifedipine and lidocaine topical compound. I was told to use this externally and internally.