OK, so I have been having on and off painful BM and bleeding for over a year now. In Febuary this year I went to my primary care and he suggested suppositories for what he thought was hemohroids. I used them for 2-3 weeks and the pain got worse. Went to a special DR and he found a fissure in March. I used a Nifedipine cream and sitz baths for 4-5 weeks and it healed. In May I did a bicycle race and it broke open. Pain and bleeding again. Did the Nifedipine and baths to heal it. July I am having painful BM and bleeding again. The pain seems farther up into my rectum them around my anus. I made an appointment to see a colorectal surgeon that works with the Dr that diagnosed me with the fissure. Today he said I have another small fissure and a skin tag. Yet he never really did an exam?? just a quick peek. He said " I don't want to do surgery for such a small fissure?" " If it debilitates your life then come back in." He gave me another cream " muscle relaxer" to use for the other fissure. My question is... Does this seem right? Or should I get a second opinion?
I am thrilled I am not getting surgery, I just feel like he didnt care during the appointment and exam. It was like a 3 minute appointment.
Has anyone has success with a muscle relaxant after multiple uses with Nifedipine?
I need suggestions!!

Hey there,
I would get a second opinion, only because I know the surgery is the best and real cure. I can't understand why a doctor would not want to do the surgery and expect someone to have a life on a roller coaster with fissures. It really makes no sense to me. The size of the fissure shouldn't matter. It seems to me that if one forms and another one comes back, then your sphincter is in spasm or too tight! I don't know why it would be necessary to wait until your life is debilitated.
With that being said I have to say-I'm very pro-LIS...LOL. I had a great experience. My CRS never said how big my fissure was or even hesitated to do the surgery. She didn't push me into it but when I said I had enough, she did it and had confidence it was the answer.
You have a skin tag, your fissure is chronic and that should be enough in my opinion to get the LIS.
What is the name of the cream muscle relaxer? I know all of the fissure ointments are suppose to increase blood flow and decrease anal resting pressure but honestly once a fissure is chronic, I don't think they do much besides give a little relief. My spasms or tightness never stopped with the diltiazem with my chronic fissure.
Hopefully others will come along soon and offer some advice:)

Hi Trifox
Sorry to hear you're having trouble. I had a similar experience to you, with my GP and also with the doctor I went to see at the hospital (I even got given suppositories the first time it appeared- hurt like hell don't they...) My GP seemed to think having a fissure on a long term basis (I've had mine for about nine months) and not having surgery for it was fine. She says she thinks it will just heal on its own, without surgery, just creams like rectogesic and movicol or lactulose.
The doc at the hospital couldn't actually see the fissure that day (like you, I feel mine heals and tears on a regular basis). he diagnosed internal hemmies and whilst I'm in no doubt that I have them too, the fissure is still an issue in my opinion. I also have a skin tag and from what I've read on here and elsewhere fissures with tags can be more stubborn to be rid of...Like you I also felt that the doctor at the hospital was brisk and uninterested- and frankly more concerned instructing the student docs he brought in with him than speaking to me!
Have you tried rectogesic before? Generally its been great at keeping things under control for me although not ideal on a long term basis I guess. That may be what the muscle relaxer he gave you was. Also wondered if you're living in the UK and seeing your doctor through the NHS. If you are that might be making a difference. It seems lots of people on here, myself included, are having a hard time getting taken seriously and going private may be the best option.
As I haven't had the surgery yet, there'll be much more well-informed folk on here than me to advise you whether just leaving things or pushing for a second opinion is best. Insofar as it seeming "right" people on this forum seem to have had such different experiences with doctors, so it's hard to tell... If it didn't feel right for you, then I think going back may be best. I think it's also a really personal thing and if the fissure is making you unhappy or interfering with your life then you MUST go back and get for another appointment. It's just not worth suffering like that. Did you explain about the pain further inside? It may be hemorrhoids but its definitely worth them checking out. For what it's worth, I will be going back to get another opinion in the next few weeks.
Hope it all works out for you and best of luck :)

I was placed on Nitroglycerin 0.3mg ointment. It seems similar to the Nifedipine that I was given in March. Both are dialators. But I am up for anything that is differant and going to work.
Thank you so much for the replys. I didnt know if I was nuts by thinking I needed surgery and then the DR said " No, it must ruin you life first" sarcastic:)
I feel like I may have hemorroids though. My soreness and pain seem higher up and a little differant. But still a sharp pain and bleeding.
I might get a second opinion after I have given the Nitro a try.
What is a retrogesic?

Hey Trifox,
I think there are a few Drs. out there want who you to try everything before the surgery. Hopefully the nitro will give you some relief, but you could definitely get a second opinion and hopefully get a CRS who is willing to give you the surgery. There's been quite a few people in here who went for two or even more opinions before finding the right CRS.
Your fissure is chronic and most CRS shouldn't have a problem with doing LIS and getting rid of that skin tag. There was a boardie in here who had the LIS after just after having her fissure a month. There chronic at 6 weeks and it makes sense that we try other things before having the LIS and hopefully the nitro will help you out, but yeah I'd personally be on the look for another opinion. Good Luck:)
Here's the link on the boardie I mentioned above and frankly... If I hadn't of been such a chicken about my surgery I know I could have had it sooner.
http://anal-fissure.org/t1905-i-m-new-hello-just-had-lis-tuesday#44163

Just to let you know, rectogesic is a nitro cream that relaxes the sphincter muscles so the fissure heals quicker. Basically the same/similar to what your doctor has given you. Lots of people have found it to be really effective although it causes headaches for some people too.