Question about nifedipine application

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Question about nifedipine application

Postby Juls814 » 31 Mar 2013, 16:45

Hi everyone..
I have a question about nifedipine application. My GI doctor initially told me to use it 4x a day. Then he suggested that I use it more if needed, because he wanted me to use Advil as little as possible so he said to just use a little less each time. I am wondering if you guys apply it during specific times? I am asking because I seem to be having spams mainly in the morning a few hours after bm. And because I have been trying to help the fissure heal, and trying not to take painkillers, I take a lot of sitz baths during that time. I'm wondering if I apply it a few times during the " spasm" stage, would that be best? The dr. also said not to fully insert, just slightly..I see a lot of people insert inside, I'm wondering if that makes a difference? Thanks for all your help.
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Re: Question about nifedipine application

Postby Just 'Pain' Tired » 30 Apr 2013, 22:41

I think I can help. I've been using nifedipine and/or a similar ointment (ditilizam) for weeks. The idea is to get it up in a little ways in order to improve blood flow and minimize the unpleasant sphincter spasms. My first doctor and pharmacist didn't tell me this, but on-line research and consulting a naturopath/hemmie specialist helped. My AF is up inside, near the sentinel pile I can feel from the outside (lumpy connective tissue outside the anus). So, I just put some ointment on my fingertip (I took to using gloves so avoid washing hands so often), lie on my left side with right leg bent (same position as rectal exams), take a breath to relax, and put it up inside--not deep in , maybe just an inch or so and smooth it around. I was instructed to use the nifedipine 3 times a day and before and after every BM. This doesn't always work out, but for me is especially important in the morning before the first (and often most painful/difficult) BM. After a sitz bath, apply more. Keeps that muscle from spasming. I have found these ointments to be an important part of managing this condition. Both my traditional provider and naturopath recommend this as a phase of treatment (if it fails, on to botox or surgery). It was really hard for me to get used to this procedure but pain is a really great incentive! Relax and good luck! Other posts have mentioned using applicators if it is too uncomfortable to use your finger! :)
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Re: Question about nifedipine application

Postby bgd » 01 May 2013, 05:40

I can see many people on the board are using nifedipine and diltiazem (don't have them on my local market). Can you guys confirm that these ointments work well in reducing spasm? Can anyone tell me the pain level before and after?
Thanks
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Re: Question about nifedipine application

Postby Anne37 » 01 May 2013, 06:09

I'm not sure about diltiazem, but nifedipine is a prescription drug so guessing diltiazem is too. It's sort of the first step toward recovery your doctor will try, along with a higher fiber diet. Whether or not the ointment works depends on the person and the fissure. I've had it cure fissures in the past, but more recently it did not work at all for me and I wound up having the LIS surgery. I think the key is to act early and use the nifed cream asap before the fissure becomes unmanageable. Good luck!
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Re: Question about nifedipine application

Postby Just 'Pain' Tired » 01 May 2013, 10:14

I'll just add that both are prescribed (here in the US); I have had the nifedipine mixed with lidocaine (pain reliever). Both had to be mixed or compounded, which not every pharmacy does. I have found both to be helpful in minimizing spasm pain.
I like the quote from Anne37 above about pooping butterflies! :D
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Re: Question about nifedipine application

Postby Juls814 » 03 May 2013, 04:23

Thank you! I have been super busy and didn't get a chance to reply and say thanks.
I did much research too and began applying nifedipine inside as well, however, my CRS doctor gave me Canasa suppositories which almost immediately stopped my spasms, which were so bad they kept me out of work. The drug is ridiculously expensive though. I actually scheduled LIS, but after a visit to the GI doc for additional issues, he told me to try the nifedipine for at least 3-4 months and that the surgery will always be an option if I choose. This is my first bout ( hopefully LAST) with a fissure, and I let it go for over a month thinking I had a nasty hemmoroid so wasn't treating it properly. Using Miralax daily and changing my diet really helped too.
I agree with Just Pain- great quote!!
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