Hi All
It already feels soothing to know this forum exists. Thank you all for this forum and your helpful participation.

I have been struggling with fissures for at least a couple of years. I am 41 years old. My family doctor prescribed various ointments with no success and 8 weeks ago I saw a anorectal surgeon for the first time. He prescribed a regimen to follow for 6 weeks as a step before considering surgery. The regimen is 3% diltiazem ointment 3 times a day, taking miralax daily and a soluble fibre supplement.

I have 2 fissures and one seems to have healed while the other still bleeds occasionally. I also find the diltiazem irritates the skin around my anus and has even caused a couple of raised irritated bumps...which I dont believe are hemmrhoids but more so irritation.

I get so demoralized when the fissure bleeds after certain bowel movements (usually if the bowel movement is just slightly more firm). and wonder if these things will ever heal. The fibre supplement seemed to make my stoolharder despite drinking lots of water...so I have stopped the fibre and continued with the Miralax. Otherwise I eat a mostly plant based and low carb diet.

I'm so afraid of surgery and also that I may never be able to have intercourse without injuring myself. The follow up with the surgeon is in 3 weeks and I dont feel certain that the fissures will be completely healed or if they healed when I s.see him...that they wont just open up again when I have a regular bm. I tend to hold tension in my butt and wonder if that made it more likely that I got the AFs in the first place.

Thank you so much for even reading this and offering any advice or suggestions you might have!

Adam

Welcome Addieto! Is your diltiazem compounded with anything else, like vitamin E for example? I tried the diltiazem and it seemed to irritate/dry me out as well. I started using a different compounded cream with a base of nifedapine (does the same thing as diltiazem) and it seems to be helping more with none of the skin irritation. Mine has vitamin E and A, plus calendula as well. I'm not sure why diltiazem is usually prescribed, but I am paying out of pocket for the stuff I'm on now, so it might be an insurance thing. Also, try not to get discouraged! My CRS told me it takes some people 3 months of topical treatment to heal the fissure and up to 2 years for the skin to be as strong as it was prior to the injury. I hope today finds you feeling well.

thank you so much for welcoming me Talesofmytail!
This dilitiazem is compounded with a numbing agent but i don't think it has vitamin E or any other soothing ingredients. I think it did slowly heal one of my fissures but the other hasn't healed and seems worse since i tried to go off of the miralax. (I have started using the miralax again to ensure softer bm's).

I was considering picking up these hyuarolonic acid suppositories (website below) for AF's and wonder if you think they could be helpful alongside the dialtiazem. Thanks again!

https://www.proktis-m.ca/

Do you have pain or just occasional bleed

Hi Mark
I have occasional bleed and mild pain during the bm and for the hour after. Otherwise I am lucky to report that I am not sitting in pain all day :)

Are you trying Sitz bath after BM and coconut oil

Thanks Mark -- I am doing daily Sitz baths but haven't done coconut oil -- how have you used it?
Also, Miralax works to soften stools but gives me gas and weird messy bm's. Ive wondered if a stool softener (like Colace) would be a better fit but am nervous to mess with a mostly good thing. Do you have thoughts?

Addieto how are you now? How was your check up? I've had my fissure for 5.5 years I had Botox for it 1 year ago and that helped but didn't heal it or fit the problem but has definitely helped.

I’ve been suffering for many years and really know your pain, have a look at my diary on here. Sending hugs!

Ff x