Hello all, I went to see a general surgeon for what an AF I had last August. It is the same doc I saw the first time and I remember he gave me the following -- Lidocaine HCI 3% -Hydrocortisone Acetate 0.5% cream and I swore he gave me some suppositories but I can't remember for sure what they were or really even if he gave them to me. I might have used over the counter suppositories.
Anyhow, this time I went back he gave me a prescription for what I thought was the same stuff. However, I only got the Lidocaine HCI 3% -Hydrocortisone Acetate 0.5% cream from the pharmacy. When I asked them if there should be suppositories they said that the kit was it. It has 20 tubes with 20 applicators.
My question is, does Lidocaine HCI 3% -Hydrocortisone Acetate 0.5% cream do anything to actually heal a fissure or is it simply to keep the pain and itch somewhat at bay? It's been a couple of weeks and I've been using this stuff but not getting any better and actually the last couple of days have been as bad as any.
I have read about some other things used to actually try to heal the fissure and I don't believe I have anything like that. I am doing all the right things, eating fiber, drinking water, stool softeners and sitz baths, but I think I might be missing a piece of the puzzle.
The surgeon I saw speaks horrible english so I can't really ask him. I am probably going to make an appointment with a different surgeon who speaks english but was curious if you guys thought something is missing from what he prescribed?
Please respond. Thanks.

That's not going to be very effective if you truly have a fissure, I'm afraid. Maybe if you had a hemorrhoids, but not a fissure. The lidocaine may dampen the pain a tad, but the hydrocortisone won't do much.
First line treatments for fissures usually consist of one of the ointments:
0.2% nitroglycerin (this one has the most side effects but I personally find it to be most effective)
0.2% nifedipine
2% diltiazem
In addition, a high fiber diet and stool softeners (docusate sodium and Miralax are amongst the favorites here -- I'm partial to the latter myself) with lots of water are staples when one has a fissure.
If those don't work, then more aggressive treatments include Botox injections or surgery (lateral internal sphincterotomy and/or fissurectomy).
I'd definitely get one of the ointments above rather than waste time with the lidocaine and hydrocortisone. To be honest 3% lidocaine and 0.5% hydrocortisone is pretty low concentration, too. You can get up to 5% lidocaine over the counter and up to 1% hydrocortisone over the counter. Even for hemorrhoids most prescription hydrocortisone creams are 2.5% and up.

I can only second what NeuroppathicGuy said !!!!!
You need to find another surgeon ASAP and start with real and proven fissure treatments !!!!
Lido and Cortisone can only be there as ADDED helpers and NEVER a primary ones !!!!
Best of luck

Also, the sooner you can get the right treatment, the better :) So many of us here have been jerked around by doctors prescribing the wrong things, which delays proper treatment and makes the fissure even harder to cure. I personally used hydrocortisone suppositories from my primary care doc for about a month before I found this site and figured out what the right treatment really was. Then I talked to a colorectal surgeon and they immediately recommended the exact same treatments that I read about here!
I'm guessing maybe your current doc doesn't know much about fissures. If you find a colorectal doctor or even a GI doctor, I'd bet they'll know a lot more.

I can't believe a CRS would prescribe Hydrocortisone and suppositories for a fissure, most of us on here know that long term use of Hydrocortisone causes thinning of the skin and pushing a suppository up there is a definite no-no, what NG says would be the correct lines of treatment, initially, then if they didn't work then the option of surgery should be considered, it seems you, like many of us on here have fallen into the hands of a rookie CRS, I say this because we've been there ourselves, it definitely pays to shop around for a good CRS, I personally have seen 4 different ones until I found the one that suited me and knew what he was talking about.
In the meantime i'd discontinue the use of Hydro and suppositories (i'm not a DR btw, just giving friendly advice) i'm sure most will agree, also, keep up with the high fibre diet and plenty of water, and ask your GP about Nitroglycerin (Rectogesic) as a first line of treatment.

It was actually a general surgeon who prescribed this stuff for treatment, I am seeing a CR (or I guess an assistant physician at a CR's office) on Thursday and hopefully they will prescribe me the right stuff.

Good luck tomorrow mj, even if your doc doesn't offer you the ointments, be sure to ask about them. They have references that they can check to be sure it's indeed the right stuff to give. I'm actually surprised (more like impressed) that you've lasted since last August without the right stuff.