I've been using Diltiazem for just under 2 weeks and have noticed an improvement in the area, BM's are definitely more tolerable and the sphincter is more relaxed than when I was using nitro, as for side effects, i've been feeling a bit light headed/dizzy and when I apply the ointment it tends to burn a little, both these things made me a bit panicky but feel it's necessary to continue on, I also suffer from hypertension so using the dilt will help with that too (hopefully), which is maybe why i'm getting light headed and dizzy I have about 4 more weeks to go using the ointment then I have to go back and see my CRS for an update, so all being well I could be doing ok (fingers crossed), if not, i'll be looking at an investigation under anaesthesia with possible LIS.
Will keep updating as things progress

Wow that's great Steve. The burning sounds a bit worrying though! How long does it take before that sensation dies down?
My continued use of the Rectogesic is helping I think, very slowly, but I'll certainly ask my doctor about Diltiazem when I see him in 2 months time.

Hi stephanie, the burning sensation doesn't last that long thankfully, it's more while i'm applying the ointment, good luck with the Rectogesic, I used that for over a year and it seemed to help at least for a while, but I wasn't 100% devoted to a diet when I first started using it so it didn't work properly, now that i've changed my diet and give up old eating habits for good it would probably be more effective, anyway it's too late now and Diltiazem is the last in the line of topical treatments so i'm hoping it works otherwise i'm having the op!

When I use Diltiazem it'll burn a bit for about 5 minutes or so, but it's nothing intolerable. Once the initial discomfort is gone it works great, though my fissures not really healing. Certainly provides some relief

I agree jman, it's better than nitro, for me anyway, I can notice the effects almost straight away, once that initial burning has gone the area is definitely more relaxed, whether the fissure is healing or not I don't really know, but i'm just glad of some relief!

Local burning is "normal" for all of those creams since they cause vasodilatation (widening of the capillaries )and that causes burning and itching sensation.
For some patients it can become 24/7 sensation and than it can become a problem. Over-sensitivity develops and creams have to be discontinued.

Thanks for the info Fissy, developing and over sensitivity would be a nightmare at this stage, after all, this is the final non surgical treatment left, fortunately the burning does wear off after a short while and is tolerable, for now anyway!