I don't use any creams. I will deffinetly consider dilation in a few months

[quote="butthurt2013"]You are lucky not to have hems. They make everything worse, if they go external, they take up valuable real estate in a very crowded neighborhood and the residents get angry, if you take my meaning.

Oh, I never know you are supposed to dilate your ass if you have AF. I thought you are supposed to leave it alone so it doesn't cause more "tearing".
This reminds me of something... I am a gay bottom and I've been having fissure problem on and off for 4-5 years now. I never knew what it was.. I thought it was just "part of anal sex" pain.
Anyway, I brought this up because last year between April-June I was experiencing very very minimal AF pain even after anal sex. I wonder if that's due to "dilation"? I would finger myself to stretch which is very similar to dilation?
I am determined to heal completely so I've told myself not to even finger myself for 6 weeks but this post makes me re-think.
Why do we need to dilate our sphincter? To reduce the spasm?

By the way, where can I buy Diltiazem cream/ointment? Can I buy it from CVS drugstore?

Hi there buttquestion. For me, the vast majority of my pain seems to caused by an overly tight (spasming) internal sphincter. I say this because I have had tremendous relief from loosening that muscle through dilation. Relieving the pressure periodically (whenever I have pain) has also given me the impression that the fissure is healing. My general pain level is way down. The length of time after a BM that I spend bedridden/in agonizing pain has gone from every single time for as much as 12 hours to sometimes having no pain at all. When I have pain post BM I clean up in the shower then apply diltiazem and dilate and the pain usually clears up pretty fast now.
Diltiazem is Prescription only, but not terribly expensive, and completely worth it. And it's compounded with surgilube (not a cream or ointment), so it has the consistency and look of thick K-Y.
I wish you well with your healing.

Status update here-
I had 24 hours straight pain-free. I couldn't even feel the fissure at all, it was heaven. I thought I could get away with eating some fried chicken and now I am paying for it. Diet (posted above) is a really important component of the healing process for me apparently. The fried chicken made me have a couple really acidic bm's way ahead of schedule, which aggravated everything downtown.
That was last night. This morning I had more pain from the fun last night. BM, hot shower, dilation (about 2 min). I'm writing this 25 minutes later, and the pain is slowly fading. Pre-dilation this would have been a setback to what feels like square 1. Now, I'll be ok in a little while and be able to get on with my day, pretty much like normal.

Hi,
So I stuck my finger up my butt today and boy was that inner muscle tight! I have had this fissure since '09 but it's been active since early December. Diltiazem worked back in '09 but not this time. I'm on Nitroglyc ointment and it's not working either. The pain is manageable but still enough to make life suck. I cut my nails, filed em smooth, coated the finger with nitro ointment (even though it says external use only, and dialated myself. It was a little scary and uncomfortable but I can see that external ointment isn't working because it's inside where the muscle is tight. Thing squeezed my finger like a Chinese finger trap! I will continue to try this for the next few days and let you know if it helps me.
-Dangading P.S. My girlfriend thinks I'm causing my fissure with my mind or something. :(

Dangading-
I agree, any muscle relaxer must make it to the muscle that needs relaxing, which is internal in this case. Please do give updates, I'd love to hear that it's working for someone else as well as it is working for me. And your girlfriend might not be too far off of the truth. When I get stressed out I can feel the muscle tighten up (you get more conscious of it as you mess with it more), and of course that keeps the fissure open and not healing. So, not terribly indirectly, your mind COULD be causing it to remain a problem at the very least.

If anyone is still reading this-
It's still going great with dilation. The fissure is healing more every day, in fact it closed up, now it's a small bump.
So last night I forgot to take my "cocktail" of laxatives and stool softeners, woke up in a panic, anticipating volcano status for the morning bm. Instead, it was just slightly uncomfortable, with little or no pain, period.
I did my normal ritual after, shower, diltazem, dilation ( I go about a minute or two, any more doesn't seem to have any increased effect). I got dressed and literally went over to the comp to type this, zero pain sitting at comp, which is a miracle I never thought I'd experience again.
If you haven't tried to dilate yet and are still lying in bed all the time wondering when you are going to get better, I would strongly recommend getting over whatever is stopping you from trying it. IT'S A REAL MIRACLE, AND IT HEALED ME.
I hope you all find relief any way you can.

I believe the best time to dilate is right after Sitz Bath because warm water relaxes the muscle.
My only concern is I don't know if dilation would tear the fissure... I've been doing 10mins every morning for the past 3 days.