So apparently I have a fissure, on my second day of applying the Nifedipine & Lidocaine cream that my primary doc gave me. My so-called fissure only stings when I pass stools. I have a bit of blood spotting on tissue when going too. Probably not much, but a bit scary. Both creams say only to use on outside, where I think my fissure is. I have two small skin tags but neither are in terrible shape. I've had them for years with no issues. I've had this for about a month since a hard bowel movement where I strained some.

What I'm wondering is this. How long before these creams can stop the spotting? The stinging isn't too bad, the Lidocaine seems to help some, but it's still there. I can handle it. What I really want to stop is the blood on tissue after wiping. Will these help stop that? Years ago I had some type of white steroid cream for a suspected hemmroid, bleeding stopped very quickly. How long should I give Nifedipine/Lidocaine to work? My doc told me that have a high effectiveness rate. My stools have been soft lately, but yet I am still having some blood on tissue. I'm really hoping these will work, maybe it's just not been enough time yet.

Is there anything else I can get to promote healing/stop the blood spotting when having bowel movement? Zinc tablets/ointments or maybe B6? I'm going to try taking them and see what happens. In meantime, guess I'll continue applying the ointment. They say to NOT put them inside only outside, so that's what I'm doing. What if my fissure extends slightly inside the anus though? Will they still help this?

What sucks is I also have bipolar disorder and anxiety, and this is really causing me a lot of mental distress. It's sad to live in mortal terror of bowel movements. Like I said, the pain isn't so bad, it's seeing the bit of blood on the tissue that scares the hell out of me. I'm going to get some zinc & b6 tablets & see if they help any.

I go see my doc again in 3 weeks. If there's still not much change, guess I'll ask for Nitro or maybe a steroid cream.

Hi Alex,
Welcome & really sorry to read of how traumatizing your fissure is for you.
It's truly a torture for all of us that have had to deal with this issue and we are with you, but please try to reassure yourself that you will get better & life won't always be like this.
A bit of bleeding is completely normal for pretty much all sufferers, so you are so not alone in having to deal with it.
Are your pain levels reducing and are you feeling more comfortable? If things seem to be feeling better, your fissure has possibly already started it's healing process and as things improve, the wound will become stronger and less likely to bleed.
Zinc is great for wound repair as well as is Vitamin C & the B Vits as you know.....Lots of fresh fruit, salad & veggies too.
It's also difficult to say right now when the Nifedipine will truly start to help the process moving - It could take a week to a few weeks but generally it's about two weeks or so that people start to report effects of pain relief.
Differing CRS' have varied views on how to apply Nifedipine, but it seems to be the general consensus that it is more helpful & effective when the cream is applied internally. The higher you can get the cream to the sphincter muscle, the better. Some people use small syringes, like the ones in Anusol (piles) packets to help the process.
Unfortunately, it is possible that you might continue to spot for a little while longer whilst you are getting better, but please try to reassure yourself that this is just a normal thing and as you get better, this will all go away.
Wishing you all the very best & hoping you heal well soon :) Stay strong

Thanks for the encouraging words. One question I have, I am a gay man, but have not had any receptive anal sex in over 4 years. Or any kind of anal contact for that matter. I am sexually active, but only with a guy I was dating long-term until parted ways. Is there a chance this "fissure" could actually be syphillis or anal herpes? I have no reason to think this, but it does make me wonder, if you actually have to have receptive anal sex to get anal herpes. Or can you get it through any kind of sexual contact? My doctor said he didn't see think it was anal herpes, but I wonder..I have a whole bottle of Bactrim left over from when I had a urinary tract infection awhile back, that I never used, I think I'll take the Bactrim and see if the fissure improves. If it does, maybe that means I have anal herpes and that's the root cause of my fissure. Maybe I'm just grasping at straws, but I can't help wondering..

Hi Alex,
Herpes is spread by contact with another person's skin that is releasing the herpes virus. Usually there will be sores showing the presence of an active herpes outbreak, but not always. Any contact can spread the virus - it doesn't have to be sexual.
I did a quick search for herpes and anal fissure, and apparently it can cause fissures.
But you say you have no reason to think your partner has herpes or syphilis? In any case it makes sense to get tested for these STDs. That way you can either get treated, or, if you come up negative, your mind will be set at rest.

But Bactrim will not help you, as far as I can tell with a quick search. Herpes, being a virus, will not be affected by Bactrim at all. You need an anti-viral. I forget what they call it now, it used to be called acylovir, and it is very effective. (I used to do research on the herpes virus).

For Syphilis, you need penicillin or doxycyline. If you have syphilis, which does sound doubtful, and I hope you don't, it is a very serious disease, and you need to get it taken care of soonest. Long term it can affect your brain. Like I say, it seems unlikely you could have it without knowing, but still, it's best to be absolutely sure.

I do strongly recommend getting tested and getting the correct cure (if you need a cure).

Best of luck!

Hi Alex! I can imagine your anxiety. When we do not know exactly what is going on, we sometimes worry too much and imagine worst possible scenario. I am the same myself but I know it is not helping with recovery. So try to relax, you will be o.k. , it will just take some time. I think it is better not to take antibiotics without doctors advice. Herpes is a virus and Bactrim will not help with it. And I think I read that antibiotics were in most cases useless against fissures in fact I got it with antibiotics and doctor told me it is common. If you have no reason to think you are infected and your doctor checked it I think you have no reason to worry about infection, but concentrate on healing present fissure with prescribed cream.

All good points. I have been sexually active, I haven't had receptive anal sex, but have had oral sex, kissing, & had sex with my partner (he was receptive). No reason to think he had an std, but one never knows. We broke up recently. So this fissure thing I've been having for the last month makes me wonder if it's some type of std back there. When I looked at my ass with a mirror, I noticed what looked like a teeny tiny little white boil on the right skin tag, which is where the discomfort seems to come from. Don't know if my doc saw this or not, or if it's related, but I wonder..

I had shingles a few years ago, Acyclovir the anti-viral was wonderful for that. I'll probably just visit the local health department & get tested, if you tell them you think you might have been exposed to an std, even without hard evidence, they usually treat you anyway preventatively. I went once in the past, and they did just that. So I'll probably do that as a precaution. Couldn't hurt.

The only reason I suspected anal herpes, is that I never had a fissure before, & so just wondering if it's some type of std. I haven't been tested for stds in awhile, so I'll probably visit the health clinic next week & get treated. If I remember correctly, they give a one-time big injection of penicillin in the ass, & some oral tablets, to preventitively treat for herpes/gonorrhea..As for syphillis, they have to do a blood test for that, but if I go, I'll probably get test for everything, just to be safe.

My doctor told me last week when looking at the area, he didn't think it looked like anal herpes, that he didn't see the need for a culture, but nobody would know unless I was tested. So for now, I'm going to try sitz, water, fiber, and the nifedipine & lidocaine & hope that helps a bit.

So guess I should just hold off on the Batcrim?