Hi, I use the nitro cream but when I first start I mix it with a bit of aquaphor ointment to cut the strenght a bit. It helps til you get used to it. You can also take something before you get the headache. I've tried that too and it seems to help. Suzy

I've been taken off the rectogesic and given a diltiazem cream instead. I've also been given an antidepressant as a painkiller :roll:

Give the Diltiazem a chance, if you get severe itching use a lesser amount and try to get the most of it up inside the rectum, I'm saying this because it works this way for me and the itching will drive you insane.

Well I thought the Diltiazem was workign as it seemed to have healed and been ok for the last 2 weeks, but no, had another bleed this morning after a firm BM, despite fybogel and laods of water. Fed up now, had a fissure 3 times in the last year, normally taking about 4 weeks to heal, thought this had but now its back, and only been helaed two weeks. Dotn really know what to do anymore

painful, that's the thing with fissures, just when you think they've healed they come back with a vengeance, btw I had mine under control with Diltiazem, just had severe itching then it started again, it's a vicious cycle of healing, tearing, healing, and with that comes scar tissue which in itself causes additional problems with further healing.
The only real way to get rid of the scar tissue is LIS and give your fissure the best chance of healing. LIS is by no means an instant cure though, you still have to be really careful with food and BM's of which I'm still learning!!

in almost 7 years of all this fissure business, i finally was given diltiazem 2% and lidocaine 5% before my trip on 12/28.
it has been a miracle.
mind you, i had anal pain but no bleeding so bleeding wasn't an issue.
the diltiazem and lido at first helped stablize everything.
after 3 or 4 days, no need for lido. kept applying dilt.
today was a dilt free day.
i didn't experience any itching what so ever.
i am still going thru the LIS/skin tag removal next wednesday; definitely the skin tag removal and i will leave it up to the doc if she thinks LIS is still needed. i haven't felt this normal since my start of issues before end of november.
the diltiazem and lido cream worked amazingly well by day 2 for me and by day 4 or 5, i only really just needed the dilt.
good luck.