I was diagnosed by my family Doctor about a month ago with a AF. He prescribed some HC 2.5% cream and supositories, Seemed to be helping until I had a somewhat hard BM earlier in the week and now it has returned with a vengence. Possibly came from Memorial Day gatherings, that type food..I'm scared to go poo it hurts pretty bad and then the pain seems to steadily get worse for a few hours afterward and then starts to get better until I have nearly no pain until my next poo again. My question is, is this normal in a fissure that is trying to heal? When I go it feels like I'm pooing razors. I called the Doctor yesterday and he prescribed me a nitroglcerian cream, I used it once this morning and seems to have helped. Guess I will find out when I poo next. I am trying to eat soft foods, taking a fiber suplement also, eating lots of fruits and veggies. Am I on the right track? Keep the course and this should help? Also does anyone know is it ok to use the HC cream in different intervalls with the nitro cream? Failed to ask him that yesterday, If anyone has some good advice I would love to hear it!!! Thanks !!!

I found nitro to work over a course of many months. I also take Metamucil 3 times a day for the fiber. None of this would save me, however, without a good stool softener. I personally have found that one recommended dose of (generic) Miralax does miracles.
I believe if my poop isn't the consistency of toothpaste, I'll just tear a new AF.

Hi Mbs,
In my opinion (but I'm not a professional!) you're in that very painful, "raw", newly-diagnosed state with your fissure, which from a pain perspective, is argueably the worst. It's great you are now using the Nitro, but would ask if you have seen a CRS or just a regular GP? A CRS is a specialist in anal issues and will be able to determine more about the fissure for you. That burning, searing after-pain is normal and can last, as you say, for hours after a BM. It's caused by the internal sphincter muscle in a state of spasm or "tightening" as it pulls on the wound edges of the fissure. Blood flow is also reduced to the area, thus making the wound healing difficult.
The Nitro is there to relax the internal sphincter muscle (and spasms) and promote blood flow to the area, which in turn, assist the healing process.
Persist with the Nitro for as long as recommended by your GP because it really does help a lot of people, reduces the severity of pain and spasming, thereby promoting healing. Fingers crossed this works for you.......Everything you are experiencing right now is completely normal and symptomatic of a fissure! At their worst, they are incredibly painful...
Keep eating the right things to promote softer than soft stools (you can find loads of helpful info on this site!) Take a stool softener if necessary and keep LOTS of fluids.........
Pre-lube your anal opening prior to every BM with Vaseline to help coat & protect the fissure & ease elimination of stools, never strain and never wipe hard with tissue - Dab with baby wipes or clean-up with a shower head. "Sitz" baths or sitting in a hot bath are really beneficial in dealing with spasms to get the blood flow moving to the area.
I believe there is no issue in using both creams but do use the Nitro regularly after BM's (at least twice daily) as this is the one to help reduce the spasms. HC will only help in providing relief to the area but this should be used sparingly as it can weaken the skin in the area - Here, it's good to experiment with what helps bring you relief (Some alternatives include Aloe Vera/ Coconut Oil/ Manuka Honey, Zinc oxide/ A&D ointments)......
I would just say thoroughly research this site - It is fantastic and you will lots of help here!
All the very best to you......

mbs1977 wrote:I was diagnosed by my family Doctor about a month ago with a AF. He prescribed some HC 2.5% cream and supositories, Seemed to be helping until I had a somewhat hard BM earlier in the week and now it has returned with a vengence. Possibly came from Memorial Day gatherings, that type food..I'm scared to go poo it hurts pretty bad and then the pain seems to steadily get worse for a few hours afterward and then starts to get better until I have nearly no pain until my next poo again. My question is, is this normal in a fissure that is trying to heal? When I go it feels like I'm pooing razors. I called the Doctor yesterday and he prescribed me a nitroglcerian cream, I used it once this morning and seems to have helped. Guess I will find out when I poo next. I am trying to eat soft foods, taking a fiber suplement also, eating lots of fruits and veggies. Am I on the right track? Keep the course and this should help? Also does anyone know is it ok to use the HC cream in different intervalls with the nitro cream? Failed to ask him that yesterday, If anyone has some good advice I would love to hear it!!! Thanks !!!

My gastro Doctor told me not to take the Cortisone enemas..because she explained to me that it thins the skin around that area, and its thin enough as it is.
My family Doctor gave me the Cortisone..My Gastro specialist changed it to a compound ointment of 0.2% Nitroglycerin and Xylocaine, to be applied in a pea size to anus, not inside. I hope that helps, If not go back to your specialist. :)

agree - do not put cortisone cream on your rear end - it does not help, and over time it does thin the skin, increasing the chance of re-injury. So many doctors prescribe cortisone.

Well, its Sunday and I don't think I can go to my nieces wedding (oldest sisters daughter).
My middle sister (I'm the youngest at 51) told me to eat something. So yesterday I had oatmeal with a pear sauce then chicken broth with lots of liquids (always).
By about 5:00 p.m I felt a BM coming,( I had to take milk of magnesia) slowly at first,An hour later, soft and larger stools, with some diarrhea.
By seven p.m I was drained..The pain started intensifying, all I could do was crawl into a fetal position in my bed and cry
Spasms all night into the we hours, I had a BM this Sunday morning, a small amount with a little sting.My sisters just don't want to here about it, can you blame them. Well going to my nieces wedding is probably out of the picture.Please take care every body

Please folks, try not to add your posts to others who are asking for advice. Much easier - for us to reply and for you to read - if you stick to your own post.
Sav