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New and have question about nitroglycerin ointment

Postby dmarie » 04 Jan 2012, 19:09

Hi -
I writing this evening because my husband has an anal fissure. He has been suffering with this for about a month and off and on for the past several years. This time, after trying various remedies at home without any success or relief I finally decided to get him in to see a doctor.
Our appointment was earlier today and the doctor perscribed nitroglycerin ointment to be used twice daily. By the time were returned home, my husband was in so much pain immediately got in the tub. Afterwards, he applied the ointment and within minutes he had severe burning and pain.
Is this normal? I read some of the other entries on the site and no one has mentioned burning or pain after applying the ointment. We were told that headaches are a possible side effect.
Help! I'm trying everthing I can, but I just don't know what else to do. It's killing me see him in so much pain.
Desparately seeking help-
Donna
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Re: New and have question about nitroglycerin ointment

Postby Davo » 05 Jan 2012, 03:34

Hi Donna,
I have been on the GTN (nitroglycerin) for nearly five weeks now and have never really heard of burning as a side effect (just headaches). However i have read my local NHS health leaflet about GTN and it states, "Nitroglycerin is safe, with mild and tolerable side-effects of headache and local burning sensation"
Sorry to ask the question but did he use the GTN shortly after using the toilet? (I know you say he went straight in the bath). If he did i would suggest he tries using it before a toilet visit as otherwise he could be using it on a fresh wound. Also is it the GTN which is applied internally (0.4%) or externally (0.2%)?? If it is the internal version maybe just try applying a pea size dose externally until the burning sensation stops. Finally if none of the above are suitable then my last suggestion would be to lower the dose and slowly build it up to the full dose and a number of uses.
Davo
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Re: New and have question about nitroglycerin ointment

Postby dmarie » 05 Jan 2012, 05:38

Hi Davo-
Thanks so much for the response.
It was a long night and I hope today goes better.
He actually applied the GTN shortly after his bath. We were given the 0.2% and your comment makes a lot of sense regarding it being a fresh wound. He was in the tub for a good half hour.
After yesterday, I'm not sure he'll want to try this again, but I don't know that he has any other options at the moment.
I will suggest he try a smaller dose prior a bath and trip to the toilet.
Thank you for the advice and here's hoping for a better day.
I'll be in touch later.
Donna
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Re: New and have question about nitroglycerin ointment

Postby Davo » 05 Jan 2012, 06:13

Hi Donna,
I wouldn't apply it straight before a bath as this could wash some of the GTN away.
Are you in the UK? If you are you can buy some over the counter anaesthetic called Lidocaine - apply this before he uses the toilet and then he needs to jump straight in the bath afterwards. Once out of the bath then he needs to apply the GTN and maybe start in smaller doses if it is causing burning sensations.
How long did the burning sensation last?
Regarding the pain there are normally two parts to this:
1. During the Bowel Movement (BM) he will probably feel a sharp knife edge pain which can be quite severe
2. Following the BM you get very painful spasms which can last for hours or the whole day depending upon how bad the fissure is. These spasms feel like a sharp burning sensation which when they are their worst can prevent you from walking, sitting down, etc. Sometimes these pains dont start until an hour or so after the toilet visit so this could be the cause of the burning sensation rather than the GTN.
The GTN is used to relax things during the spasms so it would be beneficial if he could try and tolerate things for a while longer.
Another thing which can affect things is by using cheap toliet roll - go for the quilted non-medicated type or better still use cotton wool dabbed in warm water
Davo
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Re: New and have question about nitroglycerin ointment

Postby KarenG » 05 Jan 2012, 17:51

Hi Donna
My partner also has an anal fissure and he too got a burning sensation when he applied his Diltizem (is that the same thing?) Although to be honest for the last 3 weeks hes been in constant pain with spasms from the morning when he had his BM till about 11.30 at night so for him there was no good time to apply it as it was always hurting! He actually had LIS surgery yesterday and in one day it already feels like the weight of the world has lifted from our shoulders! Like you it killed me seeing him in so much pain and not being able to do anything about it. I hope he finds things easier in the coming days x
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Re: New and have question about nitroglycerin ointment

Postby dwarfs8 » 08 Jan 2012, 19:12

Hi dmarie, I'm so sorry for ur hubby and so glad for him that he has u as the supportive half! Ok, each of us is different and we react differently to the creams we used to. If burning is an issue with the creams, u probably wld like to try aloe Vera instead. It helps me a lot. Do read up the thread "my success story".
Aloe Vera is still a bit acidic so it may sting a bit for probably 10mins after which the soothing action wld step in. Put the aloe Vera gel into the fridge before use helps too.
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