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Suggest Remedy For Painful Fissures
Question: Hi, I have experienced fissures before from passing large/hard stools. After changing diet and maintaining hydration they heal and I'm back to normal. Unfortunately, this time the fissure(s) is deeper inside rectum. I was told niphedipine/petrolatum ointment (as calcium channel blocker is not safe to use more than 1/2 inch in rectum). I have severe rectal spasms arriving before each bowel movement and after (rolling on floor in pain having to breath deeply). I am desperate to relive spasm (which continues to tear fissure). Sphincter is constricted 24hrs/day with massive spasms in between. Doctors don't want to prescribe B&O supprettes ( the only thing that works I have read). What can I take to get rid of this? Sitz are not aggressive enough to make any diff. Docs try to give hydrocortisone supps ( good for fissure( not for spasm). I'm not willing to do surg or Botox. A certain suppository must work as well as B&O .
Brief Answer:
Topical nitroglycerine
Detailed Answer:
Hello,
Sorry to hear about your problems,
A you do not wish to opt for surgery or botox, you have three options available
1. Oral Nifidepin
2. Oral Diltiazem
3. Topical nitroglycerine
I would advise against oral nifidepin due to th high side effect profile.
My suggestion would be to use local nitroglycerine ointment which will help to relax the anal spincter.
In case this doesn't help the oral diltiazem is an option( It is a calcium channel blocker too but with a better safety profile).
Along with this i would advise you to continue sitz bath., a stool softener like Polyethylene glycol and analgesics.
Please consult your doctor for a prescription
Hope this helps,
Do get back in case you have further queries
Regards
Dr Samir Patil
Topical nitroglycerine
Detailed Answer:
Hello,
Sorry to hear about your problems,
A you do not wish to opt for surgery or botox, you have three options available
1. Oral Nifidepin
2. Oral Diltiazem
3. Topical nitroglycerine
I would advise against oral nifidepin due to th high side effect profile.
My suggestion would be to use local nitroglycerine ointment which will help to relax the anal spincter.
In case this doesn't help the oral diltiazem is an option( It is a calcium channel blocker too but with a better safety profile).
Along with this i would advise you to continue sitz bath., a stool softener like Polyethylene glycol and analgesics.
Please consult your doctor for a prescription
Hope this helps,
Do get back in case you have further queries
Regards
Dr Samir Patil
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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