First my story: I've had fissures for three years. Diltiazem gave me a rash which led to an abscess. After that I stuck with conservative treatment (diet, lots of water, stool softeners and hot baths) that haven't worked very well. Seems like I'm always on the verge of an outbreak, although doc says my fissures look more acute than chronic (surprising to me after 3 years of this). Was wary of trying other ointments but doc finally talked me into giving nitro a try.
So, I've been using it for about 3 weeks. Got the headaches, which were no big deal, and felt things loosening up slightly down there, which felt good. And within the first few days, for the first time in a very long time, I had painfree or nearly painfree bowel movements. Wow! I was very excited. Since then it's been up and down. Most of my movements are less painful than they used to be, but I've had a few that were painful. Seemingly out of the blue--it's not like I'm constipated or anything. The pain doesn't seem related to the size or shape of the stool. And today I had a movement with bright red blood on the toilet tissue, but no pain. Also seemingly out of the blue--I was really surprised to see the blood there, hadn't felt anything burst.
So, I'm just curious. Does the pain and bleeding that I have had lately mean that the nitro isn't going to work? Has anyone here had success with the nitro? If you did, did you have pain and/or bleeding along the way?
Thanks in advance for any advice you might be able to offer.

Mr. Fissure,
I used with Diliatzem with success and never tried nitro, so I cannot comment on your questions. But I wanted to say "welcome."

Hi Mr F,
I tried nitro for over a year, it definitely loosens things up but hasn't healed me, the trouble with fissures that have been present for over a year is that they are chronic, I can't believe your GP said they was acute, i'd get a second opinion.
As for the pain and bleeding, I only get pain, i've never ever had bleeding from my fissure, apparently they don't all bleed! My advice is, give the nitro a chance regardless of the pain/bleeding, it can take a while to start working!
Good luck

I used nitro for a couple of months recently. It was the first thing that loosened things up "down there" for me, and was great at first. But it has caused me problems that have motivated me to quit using it.
After a few days of use, I got a really bad hemorrhoid that wouldn't go away. After about a month of that, I started using less nitro and the hemorrhoid cleared up after about a week. I had one good week, but then I got a sharp pain and dripping blood while having a BM. For the next few days, I had a thick streak of blood on my BMs and the pain worsened for about two weeks. I figured it was another nitro-induced hemorrhoid, so I quit using it. For the past week or two, I've been using Prep H and Advil, but my mornings have still been painful.
Maybe what you have is a hemorrhoid as well. I guess the nitro can agitate the tissue enough to trigger them(?)

I think nitro can work for some people. But everyone is different so it's hard to say if it will work in your case.
I've tried nitro, nifedipine, and diltiazem, and for me the nitro seemed to give the most symptomatic relief. To me nifedipine seemed like the most useless of the bunch.
I actually had my fissure nearly completed healed after months of nitro and a shot of Botox before I re-tore it.
My fissure used to bleed A LOT. At one point, before I got a grasp on what to eat and what stool softeners to use (during one week I got real stupid and ate basically nothing but smoked salmon without using any stool softeners!!!), every BM left a toilet bowl filled with red water. It tapered down after a few weeks of using nitro, but was there off and on for a while. It was usually correlated with pain but not always. I think for me there were a couple of things that determine whether I got bleeding or not:
* The size and shape of the stool.
* How many pieces the stool comes out in (more is worse).
* How much I have to push to during the BM. If the stool comes out without much effort, bleeding is less common. If I have to strain then bleeding was more frequent.
As it stands now, I only get bleeding when I re-injure the fissure. But in the beginning I definitely had seemingly random bleeding, either with or without pain. In fact I was real worried about it early on and got a colonoscopy and abdominal/pelvic CT scan to make sure there wasn't anything else going on, because it just seemed like a whole ton of blood for a little cut.

Nitro did not work for me, it was applied as Rectogesic.
I think my main problem was that I was so tight I couldn't get the goo in far enough. Maybe if I'd got it in further it might have been more effective.
How are you applying yours? Apparently for most effect it needs to be applied to the inner sphincter. Don't know if this is correct so check first.

I applied the Rectogesic with my finger, I was told at the time to insert my finger to at least the knuckle for it to have any effectiveness, I managed to do that but with pain.

I used Nitro and healed couple of times but than would re-tear after couple of weeks. I had my fissure just for couple of months so it had a higher chance of closing with conservative treatment.When fissure was closed there was no bleeding or pain.
Your fissure after 3 years can not be "acute" in any shape or form : (((. It is obviously chronic - but maybe you were lucky and did not form a lot of scar tissue so it kind of looks "fresh" ...
The fact that you are bleeding means that it is open : ((, unless you have hemorrhoid problem also and than bleeding can come from them...
Fissure healing should happen in 6-8 weeks, 12 weeks max with any cream . That was the period of time used in all studies done so far. Some people might need a longer period though - as with everything else, it is very individual. Those are just some general guidelines.

This is the second bout I've been prescribed and used nitro and it doesn't seem to work for me.
I'm considering going on a liquid diet because when I was prepping for my colonoscopy I had no pain at all--of course it might have been the massive amounts of fiber in addition to all the liquid plus 4 darvocet (by dr.'s orders) a day...
as far as bleeding--i don't--i never have--i've had fissures flare up a couple times a year for 13 years and even the first time i was blood free...