Hey there I am a 17 year old student. I'm from California. Today, I finally got to see a specialist. A couple days before I went to see the doctor I felt a lump had formed around my anus. I was terrified and the pain was horrible. My doctor told me that I was doing everything right, but the ER didn't prescribe me some medication/ointment to fully heal the fissure. My doctor prescribed me Lactulose (1 tablespoon 3 times daily), Metamucil (2 half filled cups 2 times daily), and Proctozone Cream. He told to apply the cream around my anus once at night before I go to bed. I was just wondering, has anyone tried any of these medication before? Has it worked? I'm really tired of the pain and I want this to heal so bad! It's so hard to deal with this at such a young age and especially during the summer time!!
I would like to add that my diet is spot on. I eat alot of veggies and fruits, drink lots of water, and keep a good fiber diet. These 3 months have been HORRIBLE! :(

Hey there,
I am so sorry to hear you are going through this. I will try to answer what I can and hopefully others will chime in soon.
Many Doctors and ER's are ignorant when it comes to fissure treatment. Do not use the proctozone cream. It is not suppose to be used on fissures. It is useless. I personally would start out much slower that 3 tablespoons of metamucil daily. I couldn't take it at all as it caused me to have huge bm's that tore my fissure worse. I would start out slow and take it once a day until you see what results it will have with you. We are all different in what works best.
It is very important to drink plenty and I mean 8- 8oz glasses or more of water a day when taking fiber supplements such as metamucil or you have a risk of getting constipated from the fiber. I drunk a gallon of water a day when I had my fissure. I don't think most drink that much....
Have you seen a CRS( colorectal surgeon)? They specialize in butt problems and have better knowledge of how to care for fissures. They usually prescribe one of the ointments for fissures such as diltiazem, nitroglycerin, etc.
Most of us here take miralax for stool softener. I am not familiar with lactulose. Hopefully others will come along soon and be able to add more.
I'm so sorry you are going through this. I'm not sure if you know this already but warm baths can help some too. I took 3 or more 20 minutes or longer a day to help relax your sphincter muscle and helps with the spasms.

Lactolose gave me major stomach cramps, and at the time I didn't know you had to drink loads of water with it so it bunged me up! Horrible stuff!
Yes, most doctors don't know a lot about fissures, and a good CRS is a must.
Sitting on a hot water bottle will help ease pain, and after a painful BM, a little bag (like a sandwich bag!) with an ice cube in will really help. Valium could help relax things too, and the nito cream or diltiazem is certainly worth trying as in some cases it can totally heal the fissure.
Sorry you have to go through this, it is truly horrible!

Poor you HMB! We all understand how you are suffering. I completely agree with Dawn and Val's advice. In particular I agree that you should NOT use the Proctozone Cream. It has hydrocortisone and that makes fissures worse. The doc probably gave that to you to treat the lump.
Is this lump at the same place as the fissure? If it is, then it is probably a "sentinel tag" (or "sentinel pile"). These are common with fissures, and usually indicate that the fissure is now chronic (I had one). If it is not where the fissure is, then it is probably a hemorrhoid. In that case, I still wouldn't use the cream. Instead I would take lots of warm baths and use a heating pad or hot water bottle, as Val suggests. I would also recommend that you completely eliminate all spicy food, caffeine, carbonated drinks and citrus from your diet because there is probably some inflammation of the anal tissue. Taking a break from those things will likely allow the tissue to settle down.
If it's possible, maybe you can go back to the doc and get the proper cream. I know how difficult it is to deal with doctors, especially if they don't seem like they will listen to you and they rush you. Doctors sometimes don't listen very well or take their patients very seriously - especially if the patient is young or a woman! But you can be politely assertive and ask the doctor if s/he thinks diltiazem, nifedipine or nitro would be better.
I really hope you get to see a proper specialist soon and I really hope your pain gets better soon too.
You are right - this really is horrible. These things suck. But they can get better.