just wondering,ive been instructed to use the .05 nitro cream along with some suppositories,and metamucil pills,which have seemed to help with my gas?? im on it for 6 weeks then we go to stage 2 whatever that is,then stage 3,then the knife! .guess we will have to see what happens.the cream used to make me weird feeling,slight headache but more like a headrush,you know when you stand up real quick from a nap or something,but thats gone now,lasted for like 4 days as i used the cream.its amazine how that relieves the pain that quick,why dont they make a 24 hr nitro suppository?maybe not a good idea after all...

Has the doctor mentioned diltiazem cream-that is what quite a few of us have been on-no funky side effects with that one.
What about botox? I would think in your region there may be more availability of this treatment. As far as I know it is not covered with insurance though. Maybe ask about that too-I would be interested to hear what he has to say.

Hi Dano - I tried nitro cream too. It gave me headaches, but didn't really seem to have much more of an effect than that. I used it for about 6 weeks, then moved on to nifedipine. No luck with that one either, so now on diltiazem. CRS says I'm healing with that, although after mornings like today, I'm not so sure anything is better. Thank goodness for ibuprofen!
Glad to hear the nitro seems to be working for you, though. You're one of the lucky ones. Hope it continues to go well for you,
Robin

yea,im really "caking" up in there! i hope i dont run out before my 6 week visit.my fiance[of 5 years!] says i would talk loud after applying it,like 15 minutes after i applied it... the muscle seems to have gotten less tense than it has been in awhile.when i feel around around the area,its not real tense and stiff feeling as it used to be.this has come and gone before,but i had no medicine or fiber pills or anything.the discomfort of the fissure tear is present[burning/stinging],but the tightness isnt as bad..next time im there i will ask him bout the botox and see what he says,he didnt mention it though.when he mentioned surgery,he talked a little about a small possibility of leekage as you get old and your muscle mass deterioates with age,i think we all leak something up in the age hes talking about!! isnt that strange..a shot of botox when your young to relax the muscle...40 years later a shot to tighten it back up....

Yeah, crazy stuff, huh!
LOL at what your fiance said about you talking louder after using the cream!
I think if botox was FDA approved for anal fissure insurance would pay for it and more docs would use it. Right now it is an off-label use. I think it would be a good intermediary step because it isn't permanent so if you did have problems it would be temporary. So someone like me, who can't have the surgery (due to nerve injury) could have at least tried it!

Nefedipine is also another blood pressure medicine that can be compunded into a cream and is very similar to diltiazem.
I have read that the success rate is as high with these as it is for the botox, but from my very limited experience, all three are better for provoding relief than for healing, though i believe Lecia may owe her sucessfull healing to diltiazem, in part at least.
Kim

Yes, Kim, you are right! The diltiazem was successful for me but I was also religious about taking baths and watching my diet.

I find myself pondering (now that I am not in such excruciating pain that I was desperately seeking any relief) why the diltiazem seemed to provide no relief during the 18 days that I used it. I guess it just doesn't work for everyone and thats why medicine is still an art-not all science.

Well, it worked but it took 4 months! I would have had the surgery before that if it had been an option!

seems all the creams are a "long term" solution.like it takes months to see any noticable results,then if it dont work,its on to another cream for months.it seems the botox makes sense...it relaxs the muscle,which is eveidently the main goal,for the fissure to heal,then it wears off and your supposidly good to go,why wouldnt dr's administer this first and save the time with the creams?