The CRS told me "there's no need to torture you, your description over the very same area, sounds very much like fissure you had last year." This is a new CRS from the one I had last year, he ordered nifedipine and told me to apply it three to four times a day and come back to see him in six week weeks for an exam of the area. He also suggested I take two docusate sodium (one at breakfast and one at dinner). I went through my diet and he said "a healthy diet" but not enough fibre and you need more water. I drink about 80oz of water a day, but he told me to drink more, cut out the two mugs of morning coffee and add more fibre. Just got a cereal that has 10g of fibre (less than 1 gram of sugar) and will add that to my morning non-fat yogurt. Will also continue with the olive oil.

I asked which is better "Rectiv" or "nifedipine" and he said studies have shown they are about the same, but fewer complications from nifedipine. I'll try the nif for two weeks and if it doesn't work then will ask for the nitro. Hoping to resolve this. Interesting, as a colo-rectal surgeon he told me, "I'm a surgeon, I cut things, so if this doesn't work then we should consider surgery." Hoping this process will work.

That’s all really interesting, how do you feel about it? Your diet sounded good to me - the cereal might just solve the missing fibre. Let’s keep fingers crossed this works for you.

This is a new CRS, only my second time, I'm really not feeling very comfortable. The previous doc whom I've seen off and on for several years left the area and was very comfortable with has left the area for another position. He was also a CRS and always told me that surgery was the last resort, never said "I'm a surgeon I cut things." That was a bit off putting. I told the new doc that I've added the extra fibre cereal in the past and it made me go too often, but he dismissed that and told me to just try it again. So, against my better judgement, I added a half cup to my yogurt with an orange this morning and at the first sign of too bulky or going too often I will stop.

I've actually been applying a little vaseline just before a bm the past several days and that is helping tremendously so a bit afraid that adding the extra fibre may be a problem today, but we'll see. The new CRS told me not to use the vaseline, whereas the old one told me to use it many years ago when I had a very small fissure that went away within the week -- that was over ten years ago. I'm still waiting for the nifedipine script to come in and will stop the vas once that comes in. The old CRS also had a more up to date office setting and would use a very narrow tube with a camera/light at the end to examine the anal canal, but this guy doesn't have that diagnostic tool and said he only does that at hospital and I'd need to be sedated. Didn't like that at all. I'll give the nifedipine six weeks and see that happens, but depending on the outcome may speak with my GP about finding a new CRS. Just hoping each day gets better with this treatment and will keep on my diet with some added fibre and olive oil.

Oh poor you. So annoying when your trusted doctor leaves. My fave GP recently left as well.
I use vaseline and find it very very helpful. Can you tell me why he said don't? I can't see why on earth not if it helps - ie is it stopping healing in some way/bad for you??!!
I understand how you feel about the options for examination as well. Is there another CRS you can go to? I don;t know which country you are in . I'm in the UK.
I also think that if the fibre makes you go often that's not good for the fissure. I get sore if I go more than once a day so I'd be nervous with doing something that makes me go alot. Every doctor I've seen says add fibre or use fybogel but that makes me stool way too bulky and upsets the fissure scar site.

I asked the pharmacist about using vaseline and he said no problem there's vaseline in the nifedipine, just use a little as it can dilute the medicine, but not a problem at all. So, given there's no drug contradictions, from my view of things, it's best to use what works, the doc is not there with me in the bathroom. And quite frankly, after cleaning up and before applying the nif the vas will be gone. Will see what happens with the added fibre. I'm in the US, and health insurance companies and doctor's networks pretty much control who they allow us most of us to see. There are some insurance plans that don't require referrals, but the one we have (through work) is not one of those. There was a time, when I could just go to any place or doctor, but those days are over. If not the insurance company then it's the doctors' network that works like a guild allowing you to see only care-givers in their network. However, if I really need to get another CRS then I'd have to get a new GP and new network, but have been going to this GP for 30 years and so far so good on everything else.

Best wishes to you (and all of us) in the days ahead!! Thanks

Interesting to hear how referrals work and I think it’s similar here although I think you could ask for a second opinion? Not sure actually.
Well in that case let’s both carry on with good ole Vaseline .
Keeping my fingers crossed the cream does the job for you over next few weeks.

Interesting to hear how referrals work and I think it’s similar here although I think you could ask for a second opinion? Not sure actually.
Well in that case let’s both carry on with good ole Vaseline .
Keeping my fingers crossed the cream does the job for you over next few weeks.

Yes, forward we go!! I've applied the nifedipine twice so far. Mild light headedness that passed after about an hour. But weird sensation in upper left cheekbone area, like a nerve feeling. I have also had bouts of costachondritis over the years due to an old injury (sternum pain caused by cartilage inflammation) and that seems to have been activated a bit on both doses. However, I also may have aggravated the sternum issue yesterday by bad position fixing the sink. Or, perhaps just me stressing, never can tell at times. The pharmacist told me could be from the nifedipine and will either pass with usage or not pass. We'll see what happens. Also having dry mouth after applying it. Did you (or anyone reading this) have any problems with nifedipine and did they go away after a while? Thanks.

If it’s sameas rectogesic cream then I just had headaches. It did not help me either to get better but then Ive been told my fissure has healed anyway but that It’s likely scar tissue causes the pain I still get. For me pelvic floor therapy has been the only way I’ve improved.
For open fissures I believe it is usually very good if you can deal with the side effects. They should lessen I believe in time.

Side effects are lessening, so far so good, fingers crossed!! Hope you are doing well, too.