Hi everyone,

I'm having a really bad flare-up of my fissure and have some nitro 0.2% ointment left over from a previous CRS that I no longer am seeing. It says it expired on the 1st of last month (June). Is it worth trying? I was so scared to use it when I got it that I never used it, fearing the horrible headaches that it can give and I seemed to be getting better wtihout it anyway. It's been stored away since then. Now I'm desperate because I'm in so much pain. : ( I tried a little of it this morning and it didn't cause any headaches, only stinging when I applied it. I remember the CRS said to apply it directly to the fissure, but I just don't know if I can do that. It also has lidocaine and hydrocortisone in it (not sure why the hydrocortisone is in it since I thought that wasn't good for fissures).

Also, is it worth going to the ER for this if I already know what is wrong? I'm pretty sure all they can do is give pain medication, but I'm wondering if they can give me fresh ointment or a new ointment (like Nifedipine, which I've never tried; I'm sadly allergic to Diltiazem now... I develop little red bumps in the area, like a rash) to try. Anyone have exprience going to the ER for this? It just seems like so many doctors that aren't CRS's don't know how to deal with this problem. : ( I'm really scared. This has been the worst it's been in a long time and it all happened because I got my period and it screwed everything up for me, digestion-wise, so I must have had a re-tear. The spasms and stinging of the fissure is awful. : (

Thank you for any advice you can give.

Hey Luka.

So sorry it's taken me so long to get back to you - been hectic here with the house.

I'm so sad to hear your having a rough time. I've been known to use old GTN cream at a bad flare up and I always think at the time that I can't feel much worse and it usually helps to a certain degree. Although on the other hand be wary of the Steroid aspect of the cream - that could make things worse.

You need to find out what's going on back there it seems like it might have re-torn if the cream is stinging - have you had a look with a mirror to see what's happening? where is your fissure? any blood on BM?

Be wary of A+E, I work there and I can tell you the doctors there as you mentioned have no idea about fissures. If you cut your finger off, or drunk yourself silly they'd be epic but for chronic conditions it's best to leave for the specialists. If you are in uncontrollable agony that is a priority so you would need them for a new prescription of meds but be wary they don't give you codeine or anything constipating! Don't forget their decisions bypass your CRS so he/she won't know what's going on or what's been perscribed etc.

I know my advice is so wishy washy but it's hard to know where to start when things are so bad. When are you seeing your CRS next? maybe speak to the med secretary to bump the date forward.

Sending so much positive thoughts hugs and hot chocolates.

You can make it through this - you are stronger than you think.

FF x

Thank you for the reply FF.

Yes, I probably re-tore it. I had a harder bowel movement last week due to my period for a couple of days and it was probably that. I tend to have IBS issues, where I rotate between harder and looser stools, and I haven't found anything that works for me to cure it. It flares up mostly during my period. : (

I have no bleeding (my fissure has never bled). Unfortunately, I have never seen my fissure and neither have any of the CRS's I've seen. It feels internal (I can feel where it is) and is very hard to see. They either didn't want to cause me more pain or injury or couldn't because I'm too tight. The one CRS I liked the best said he would have to do an exam under anesthesia to see it and be able to understand how to fix it. Unfortunately, my insurance does not cover him and I cannot afford his services at the moment. : ( The other CRS's did not work out (and my insurance won't cover them either) because I did not think they were right for me and did not like their methods of doing things (one doesn't even use anesthesia to repair a fissure and does it in her office!).

I'm currently waiting for an appointment with my new assigned GP under my current insurance plan, which is early next month. I don't know if I can wait that long, but they don't take urgent appointments if you're a new patient. : ( I want to get a referral from her to a CRS in their system that will be covered, but from what I've read on the website, there are no colon and rectal surgeons in their system; only general surgeons. : ( So I'm at a loss. If I had the money, I would just get the exam under anesthesia and the LIS with the first CRS I saw, but I don't and he said it would cost thousands out of pocket. I'm so lost and just want to cry because I'm so frustrated and in so much pain.

Thank you for your encouragment and for listening. I just need a shoulder to cry on right now. : ( Been having a really difficult time.