Best Fissure Treatment?

Hi there, I'm new to this website so please bear with me. I've had fissures for so long and the pain is excruciating. I've tried ointments with little success and recently have been using Percocet which has its own set of side effects. Can you please give me any info on what helps you?

I have used glyceryl trinitrate 0.4% (Rectogesic)
in the past, which has worked well, as long as you don't use too much (throbbing headache)

Nifedipine seems to be the "go-to" ointment these days. The headache side effects with nitroglycerine make it less than perfect, and with nifedipine, this is less of an issue. Botox injections are a possibility if the ointments are ineffective.

But, no matter what you use, it can take a month or more for healing to take place. Fiber supplements can help, because they make for a soft, semi-formed stool. While constipation is associated more with fissures, urgent, watery diarrhea can lead to straining too, which is the culprit.

http://www.fascrs.org/patients...itions/anal_fissure/

Jan

Jan,
Thanks for the info. It seems to have dissipated these past few days. The nupercainal worked wonders. I also went on a short cycle of Xifaxin antibiotic which also seems to have helped.

As for fiber, is it ok to eat fiber post J-pouch surgery? At one point I ate quite a bit when I had colitis prior to my J-pouch surgery and it seemed to have made things worse. Now I'm nervous about giving it another shot even though the colon is gone.

Many surgeons recommend fiber supplements, not for solving constipation, but for helping with the diarrhea. The idea is that the added fiber adds "substance" to the output, sort of like adding thickener. This gives more of a pudding like consistency, so it is less irritating and easier to retain.

But, not all fiber is equally tolerated. Many of us do great with Metamucil or other psyllium husk supplements. But, some of us are sensitive to it and it causes excess gas and it is even irritating enough to be a purgative (I am one of those). In that case, other types of fiber can be better, like Citrucel or Benefiber. Anyway, it is fine to experiment.

Jan

Just in case there's any confusion, the fiber Jan is taking about is not *insoluble* fiber, like raw veggies.