Hi, I’m needing some advice! I’ve had my AF for about 2.5 years - it developed after I had my first baby. It took about 6 months before it was correctly diagnosed, and by that time it had become chronic. I’ve managed it with diltiazem for the past 2 years (and even had another baby during that time - went just fine). But for the past 4 months, the diltiazem has just not been working anymore!! It takes the edge off the pain & maybe begins to heal it, but then it just tears again so easily. I used to only use the diltiazem for 2 weeks every other month or so, but now I’m using it every single day & still in pain. My fissure never bleeds, just causes pain.

I take miralax daily & watch my diet, so my stool stays pretty soft. But that doesn’t seem to matter. Sometimes it seems to tear when I’m not even in the process of pooping.

I had been using a diltiazem/hydrocortisone combo (now on just diltiazem) - so I wonder if I could have overdone the hydrocortisone & weakened my tissues (my GI says that can happen)?

I don’t think I’m ready for surgery yet - my GI has recommended I wait for surgery until I’m done having kids (and I’m hoping to have a couple more). So any tips?? Has anyone else experienced this? What else can I try? Are there other creams besides diltiazem? More natural methods of healing that have worked? Is it possible that I just need to keep using diltiazem straight for a few more months & I can get back to a more solid situation? Is botox a good option…?

I’m meeting with my GI again in a few weeks, hopefully I will learn some things there. But would love some help from you guys too.

So thankful for this community & a place where I can talk about my pain in the butt. <3

Unfortunately, creams and ointments don't have the best reputation as a treatment for anal fissure. Also, you need to see a colorectal surgeon (CRS), not a gastroenterologist (GI). A CRS may recommend Botox treatment, or a lateral internal sphincterotomy (LIS), but each case is different, and there is no universal cure that will work for everyone. We can't give you medical advice here, but welcome to the forum, and please keep us posted on your progress.