Hi!
I recently got prescribed Nitro 0.2% in White Petrolatum (That's what it says on the label. I hope someone knows what this is) to treat my anal fissure.
I find it works for about 30-45 minutes then I can feel the pain starting again.
Sometimes, I find the ointment is actually making my pain worse. Maybe even irritating it a little.
I've been using this for about 3 days now.
Is this normal? Maybe it does that in the beginning and then gets worse? My mom told me it hurts more because it is healing it but I don't know about that.
I need some advice and maybe some personal experiences!
If I find out this is not what is supposed to be happening, I will call my doc and try to get a different ointment.
Thanks in advance for the help!

Hi
You are right it can irritate. I was using 2% ointment, so it was ten times stronger than yours :D First week of using it was not nice for me, but than it stopped to irritate.
However if itching/pain/irritation would be stronger and stronger each day please do contact your CRS.
I hope everything will be fine for you soon!

If it carries on irritating you, and doesn't settle down in a few days I would stop using it and go back to the dr to get something else.
I hope that's not necessary though, and nitro heals your fissure!!
OMB x

Hi Youngworried,
Sorry to hear about the extra irritation. I have used both 0.4 percent nitro and nifedipine. I found that the nitro caused some additional irritation that I did not feel when using the nifedipine.
It usually takes about ten days for the medication to really kick in and get more lasting relief.
How much nitro are you applying? I found I could apply half a pea sized amount without irritation. If I applied more than that, I started getting the irritation. I think some doctors recommend using a pea sized amount and others recommend around an inch size. Maybe try less ointment and see if that helps?
I hope you start feeling better soon!

I just switched to nitro, from diltiazem, and I find the nitro burns a little when I apply it, and then my anus throbs for a while. As well, I get a sort of full feeling in my throat, and a bit spacey in my head.
The throbbing is OK I think. It means the nitro is doing its job, which is to dilate the blood vessels to allow blood to the area to promote healing.
I'm still using very small amounts in the morning and about half a pea size at night, when the spaciness matters less.

Hi guys! Thank you all for you responses.
Darkeyes: I was applying a pinky size amount every morning, and before I went to bed.
Just a quick update: I stopped using the nitro completely. I had a really excruciating flair up last night because of it. It was really hard on me. It was stingy and felt like someone was poking my bum with a thousand needles. Makes me flinch just thinking about it.
The doctors been closed all weekend but I'm definitely calling tomorrow to schedule another appointment to switch my ointment. In the mean time, I've been using "Anusol Plus" in the morning, after every BM, and before I go to bed. It's my go to ointment I used when I had some pain before.
I'm wanting to ask my doctors about diltiazem. I've heard it does wonders. Also, a year and a half ago when I had some bad fissures the specialist prescribed me it and I healed really easily. To bad I had to drop him because he was so ignorant after that. The diltiazem was the only good thing he did for me *sigh*
Anyways, any success stories about diltiazem? Maybe diltiazem vs nitro? I'd really love to hear your suggestions.
For now, I just have to deal with this pain. It gets worse as the day progresses but I'm trying to keep my head up and keep myself busy. I don't think most people understand the mental struggle that comes with an AF. It takes a real toll on your life and how you feel about it. Sometimes, I feel like just quitting. I know it sounds extreme, but I *know* I'm not the only one who feels like this some days...
I hope to hear responses from you all. Just keep your head up! I have extreme anxiety and if I can get through this, I *know* you can too :]

It does take a huge toll. When I'm having bad days, it's all I can think about. My work has suffered. Luckily at the moment things are not too bad. I have pain but it's not as bad as it was at first, and it's less frequent now.
Anyway, nitro vs diltiazem: as I've written elsewhere I personally had a bad reaction to diltiazem, much like you've had to nitro. It was really unfortunate because before I got sensitized to it, the dil did seem to be helping. Nifedipine, which I'd used before the dil, did nothing for me.
So, all I can say is, everybody is different. Nifedipine works for a lot of people - not for me. Diltiazem works for a lot of people - I can't use it. For me, nitro is the last resort. If dil. works for you, then use it. I'm amazed anyone would prescribe nitro when the other two drugs are an option. At my hospital, it is very much a drug of last resort because of the headaches it can cause.
Youngworried, I wish you all the very best of luck, and the fortitude to get through the next few days. Are you taking ibuprofen? At my worst, I was taking the maximum every day, and sometimes more. It didn't kill the pain, but made it possible to function.

Also, youngworried, are you paying attention to diet, to keeping BMs really really soft. Eat lots of soluble and insoluble fibre - use supplements if you prefer. Drink lots and lots of water, which is key to soft BMS. You can use a stool softeners and mineral oil laxatives in moderation. It might take a while to find what works best for you. For instance, some people take colace, but it gives me wind, which was very painful. So whatever you try, start with small amounts. And drink, drink, drink; water, not caffeinated or alcohol, drinks.

Scientist2516 wrote:Also, youngworried, are you paying attention to diet, to keeping BMs really really soft. Eat lots of soluble and insoluble fibre - use supplements if you prefer. Drink lots and lots of water, which is key to soft BMS. You can use a stool softeners and mineral oil laxatives in moderation. It might take a while to find what works best for you. For instance, some people take colace, but it gives me wind, which was very painful. So whatever you try, start with small amounts. And drink, drink, drink; water, not caffeinated or alcohol, drinks.

Hi! Thank you for the kind words and support! Yes, I've been trying my best to keep my diet in check. I'm actually in the middle of a HUGE diet change in my life. I'm eliminating meat from my ldiet and eating organic things! I also have been taking fibre pills! I feel like they're not working very well, but it's a trial and error thing, I guess. I also have been drinking tons and tons and tons of water. I cheated yesterday though, I had a can of pepsi. Woops! But I think I made up for it with more water, ha.
Just an update. I just came back from my doctors and was prescribed "Diltiazem 2%" mixed with...(woops forgot the name. It started with an "L", lol) that has 1.5% concentration. I'm picking up the prescription tomorrow so hopefully in a couple days I'll have another update.
Thanks for all the responses~ I would love to see more though :)

Lidocaine? That's a painkiller.
I hope the ditiazem works for you! Fingers crossed.