Hi y’all. I’ve been on nitro (a .125 percent compounded w Vaseline) for about a week now. I find it already helps with the sharp, knife-like pain I used to have following BMs. Last week I basically retore and it was agony but the nitro helped and it actually wasn’t even until 2 days ago that I began having smaller BMs (I was overloading on fiber) so I was in moderate pain the whole time after pooping anyway - a more burning, sore pain.

These past two days I’ve had great soft smooth BMs that slip right out but I still get sore and tight and slightly burning in my butt. Is that normal? Even the nitro only takes the edge off of that type of pain - but I also acknowledge that even w smooth BMs I have gone multiple times and that can irritate the fissure or even the act of dabbing w water could too.

I guess my question is, is it normal for it to still hurt a week into nitro treatment and w soft BMs? I’m just worried I might be ignoring the nitro not working, or another thing that must be addressed (eg scar tissue? Idk.) All I know from my GI - have a CRS appt in July - is that he saw a fissure (he didn’t say if I had multiple or even where, trying to get him on the phone to discuss, they’re internal from what I know so not easy to see and I don’t actually feel anything when I put the ointment on) so I feel like I am flying blind.

Thanks for any input!

A week is not that long for a fissure to heal completely. You need 6-8 weeks of complying with treatment before it heals fully..

Thank you patience and healing! So basically the pain really persists until healed, so it’s normal to have the burning and soreness even when treating w nitro…I called my doc and he said I could apply lidocaine first if I prefer but I think I’m gonna try ice packs and aloe instead if there’s soreness.

The burning usually has nothing to do with having a fissure. I don't have a fissure anymore but I still will have occasional burning irritation from loose stools while having a BM (it goes away once I'm done in the bathroom). Nitro sure gives you a headache though. I remember the second it touched my skin I got an instant headache. Good luck!

Oh interesting! Pre-Nitro the kind of pain I’d have post BM was a combo of the sharp knife type pain and a more persistent burning/aching. I assumed both were the fissure but maybe the burning/aching is more a symptom of the small hemorrhoids I apparently have too. I have a colorectal consult (finally!) next week after previously only seeing a GI doctor so hopefully he can let me know. And yes the headaches are not fun but they’ve faded enough to be tolerable thank goodness!

If you can tolerate the nitro, great. I am not sure how long it's ok to be on it but whatever works...

I used to think there had to be acid in my stool but my doctor said no. It's just the nerve endings in the anus are so sensitive. To prove it watch Randy (Stan's father) on the cartoon South Park. Yes, he has BMs on the show and he yells out, "Hot! Hot! Hot! Hot!" So the burning is not uncommon! lol

I’ve been on nitro off and on for a year. My CRS says I can stay on it as long as needed. The burning persists for me. It’s the anal spasms and general pain memory in the area that keeps it all burning! Eventually when healed totally I hope it stops but I burn all day every day… no matter how soft and painless my BM! I’m dilating and relaxing for the spasms. It’s now probs a 6/10 instead of an 8 pain wise argh it’s a long process.

Oh Hazey I’m sorry you’re experiencing this - I wouldn’t be able to stand persistent burning - I have a hard time even now with burning 1/3rd of the time / coming and going throughout my days. I spend most of my time lying down w ice packs and waiting for my next nitro dose if I’m honest. It’s no way to live but I’ve been trying to be more optimistic and get a care team around me and I’m also going to a pelvic floor therapist in August so maybe they’ll recommend dilation too!