I just wanted to let you know that I found success for a persistent fissure that lasted 9 months. I tried the GTN ointment and it got worse. Diltiazem had me fixed in 4 days!
I have had bleeding internal piles that came back about every 3-4 weeks and I use diltiazem for 3-4 days and it clears it right up.
The piles only come back when I get hard stools or do not use the toilet when immediately needed.
It is imperative to keep stools soft. I run marathons and climb mountains which caused dehydration. I have learned that I cannot get dehydrated. I have set reminders on my phone to drink water.
If I think my food and lifestyle will cause a hard stool I stick vaseline up my bum and use lactulose drink.
I have been 2 months pile free and 8 months fisure free after 9 months of bleeding and intense pain.
Ask your doc for diltiazem. They are reluctant in the UK because it is expensive. You need to get your stools soft so drink a lot of water. I am 38 and had hard stools all my life because of lack of water.
I also severely cut down on alcohol.
I also highly recommend going to the toilet normally and not being afraid of tearing. I found I needed to relax as I was tightening up and pushing strangely. Just relax and push it out without hesitating or trying to stop half way.
Good luck, don’t give up, I thought there was no end in sight.
Please reply if this helped you.