Rectiv./Nitro question 1st fissure

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Rectiv./Nitro question 1st fissure

Postby Cloud9 » 21 Jan 2013, 19:26

I am new to this forum and experiencing what seems to be my first (very awful and painful) fissure.
The pain started about a month ago maybe a bit more, but was tolerable before that. It took me a while to realize I was not just being a big baby with a hemorrhoid (because I had never experienced either hemorrhoids or a fissure). I know I have been lucky..
Gosh, I now feel so deeply for everyone on this forum and in the world feeling this awful pain! And most of the time for much longer than I have!!
Anyways. After having the GP diagnose me with internal and external hemorrhoids and trying every cream and treatment imaginable and finding zero relief. I thought, there has to be something else going on here and I made it to the Gastro. She listened to me in within 2 seconds said "you have a fissure". She wasn't even going to look at it. She just said, your next option is to go to a surgeon.
I had her look just to put my mind at ease and she said she could see from the outside, that yes I have a fissure but said only a surgeon could look further with numbing the area because of pain. Turns out the surgeon doesn't have an available appointment until the end of February! I think it would ease my mind that I am not infected or to know how bad it is if someone could at least look before then but on I go..
After trying every home treatment, sitz baths 2 times a day, 3 times a day with various things epsom salt, lavender, etc. Using coconut oil (this brought the most relief but is short lived about 30 mins to an hour and then raging pain), Dr. wheatgrass, vitamin E suppositories, even hydrocortisone suppositories which I promptly stopped after a couple days reading they will only thin things out.. I finally asked for the Nitroglycerin.
My question, now that I am finally getting to it is.. I am using Rectiv. with great relief! The only problem is that it only lasts for a couple hours sometimes. Over the weekend I kept reapplying in little amounts and found the same relief but after talking to the doctor today she says "only use it every 12 hours" no more than twice a day.
This is .4% nitro! I know its a lot to reapply. Should I not be doing this? Even if I am in pain is it still possible that waiting it out using it twice a day could help in the long run? Or has anyone else applied more during the day? Has it been safe? I do not get dizzy or headaches. I have been lucky with that too.
Any suggestions on pain relief or healing would be appreciated of course but I really want to hear if anyone has used it more or if I would only be hurting myself..
I am usually a very sensitive person (to medications) so naturally I was and still am wary or anything, especially anything going on my bum! But its so nice to finally have relief!
Sorry for the long post but I suppose it happens with first time sufferers.. Thank you ahead of time for any advice and thoughts!! So appreciate the time you took to read my long post!
Cloud9
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Re: Rectiv./Nitro question 1st fissure

Postby PIA » 22 Jan 2013, 03:00

Hi Cloud9,
Glad you have found the site it has been a blessing for me over the past few weeks. I have been using the nitro cream for two weeks and am very pleased with the results even though I get bad headaches from it. I still think the success for me comes in a combination of other suggestions I have from this forum. I try to plan my day, get up early empty my bladder, dab area clean with witch hazel soaked bay wipes and apply the recto cream around and in. I take two Ibrufren tabs, a multivitamin and fish oil. I take my magnesium and slippery elm tablets during tha day away from food and other tabs. I now have porridge with prunes, a glass of black current juice and one sachet of movicol in water (have substituted Metamucil for movicol). I also have a cup of tea. My gut usually notifies me of impending BM within the hour. On my current program I have had a really soft, consistent painfree BM.
I run a hot bath with epsom salts while I am sitting on the loo and get straight into it after BM. I sit in there for about 15-20 min. When I get out I dab dry again with w/h soaked baby wipes. If the sphincter is loose I just dab a little Vicks on the area. If it feels tight then I don't hesitate in reapplying the recto cream. I follow the same program if I have a second BM during the day. I usually use the recto cream three times with the last time just before I go to bed. I have had a few completely pain free days and a few days where I feel I have made no progress. But overall things are on the improve. Fingers crossed for you too. Xx Pia
Last edited by PIA on 22 Jan 2013, 03:35, edited 1 time in total.
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Re: Rectiv./Nitro question 1st fissure

Postby Cloud9 » 22 Jan 2013, 14:56

Thank you so much for your reply Pia I really appreciate the time you took to tell me all you are doing! I am going to try to add things like the prunes and try to do the sitz bath directly after BM. I wish you well in the healing process! You will be in my thoughts for a speedy recovery.
Can I ask you how long you have been doing this, to experience pain free days? Where you started thinking you were improving?
Thank you again and I sooo appreciate what you said about the nitro. too! I feel a bit more comfortable that I am doing just about the same as you! Gosh its good to finally find something for a bit of relief! As I am sure you can identify with!!! haha
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Re: Rectiv./Nitro question 1st fissure

Postby PIA » 23 Jan 2013, 01:34

Hi again Cloud9, I found some relief as you did within the first few days with the nitro, but it would come on again within hours. It seems that most days the relief is a little longer. I think the raging pain is possible from the sphincter going back into spasm. To try and avoid this I think the soft stools, nurafen, warm baths, a warm wheat bag and vicks in between the nitro extended the relief hence the sphincter staying out of spasm. I have had some tough days in between..like the time I stayed over at a different place and forgot all my AF box of goodies including the nitro cream. Constipation, sphincter spasm and much pain was the result of my stupidity. I hope the period of relief get longer for you. xx Pia
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Re: Rectiv./Nitro question 1st fissure

Postby sufferer » 01 Feb 2013, 23:36

Hi Pia, Cloud9,
I've been suffering from AF for the last 8 months now :( Have been trying all sorts of things, coconut oil, Diltiazem, in addition to sitz, fiber, water etc. None of that seemed to work. Just started on 0.2% nitro, twice a day. It has been 12 days on Nitro and while the first week things were looking a lot better, one bulky hard stool and I had pain again this morning. Of course, it is lot less compared to pre-Nitro days!
My main challenge is keeping stool 'less bulky'. All suggestions on this forum and outside are towards adding bulk to stool. In all the posts I have read I think stool consistency is the key. How do you manage to get the right consistency?
Pia - you said you are on Nitro for about 2 weeks, which is the same as mine. It will be very helpful is we can share progress as we go along. Hope everyone cures very soon!
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Re: Rectiv./Nitro question 1st fissure

Postby PIA » 01 Feb 2013, 23:55

Hi, I have much less pain now but there is still an almost constant tightness in my sphincter..much less than before. I can feel the degree of tightness when I am apply the Nitro ointment. Now though I can touch the area where the fissure is which was impossible two weeks ago. I can now also insert some nitro internally without pain. I try to stretch the sphincter a little more each day. My thought is that it will need to stretch when a bulky BM comes down so I am preparing for that unwelcome event. I usually apply a little Nitro with some vaseline about half hour before a BM after breakfast. At that time I can feel if there is a hard stool at the station. If so I squirt some coconut oil up there to soften the start. If it is going to be hard for me it is always at the start. I take Movical at breakfast (one sachet) as well as a tablespoon of metamucil on a big glass of water each. This may be too much sometimes and very soft stool can be result. For me I prefer this to the alternative. I think the magnesium tablets i take help keep the large amount of water i drink in my gut and help with a softer stool. Even though I am drinking heaps more water I dont pass urine more frequently. i hate how obsessed I am with my body functions atm but think I need to be until things are a little more stable. XX Pia
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