I have to say I am really happy to find this forum. I have been suffering silently for more than a year now.

I have had fissure for more than a year due to my chronic constipation and I have pain during BMs. I went to a Gastro and he had suggested fiber supplements to avoid straining and it was ok for a few weeks.

The fissure would flare up now and then but it was not really a bother.

This time it has been the worst ever flare up. Last 1 week has been the worst BMs of my life with excruciating pain and bleeding. I can even bear the pain but I am not able to bear the sight of blood.

I went to my GP who suggested a lactulose syrup 15ml every night and some antibiotics (god knows why we need antibiotics).

Anyway, my condition has not improved in the last 1 week and after a lot of research I have found

I am in India and it is possible to get most of the meds OTC and I was able to purchase a Diltiazem 2% gel. I am also using a powder that contains psyllium husk along with some herbal laxatives to soften my BMs.

I have been using since last night but there has been no improvement in the pain or bleeding.

I am looking for some real help here. Can some one help me with the following.

1. What is the best way to apply diltiazem gel ?
2. How long Diltiazem takes to show results ?
3. Is there something I can do to stop this bleeing.


Thank you so much.

So sorry to hear that you're suffering, but glad that you found your way to the forum.

My CRS instructed me to apply the diltiazem to the outside of the anus, because it is absorbed through the skin, but many others on this forum have been told to apply it just inside (hopefully others will describe how they do that). He also told me that diltiazem isn't an analgesic, so doesn't soothe the fissure, but is instead, a product that encourages blood flow and new blood vessel growth in the area that can help the fissure to heal. He told me that it takes a few weeks for that to happen (if you're one of those lucky enough to have it work for you) so don't expect relief right away. Let's hope that once your fissure starts to heal, the bleeding will taper off and finally stop. Can you go back to the gastro? Or get an appointment with a CRS? I'm sure that he might have some other suggestions for you if he knows that just upping the fibre didn't help.