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Hi everyone,
I've been having terrible cuff problems for quite some time. At the moment, it is stuck in a constant spasm and I'm miserable. I had a pouchoscopy last year which showed fissures and internal hemorrhoids. Of course I've been bleeding but the pain is almost unbearable at times. I've tried soaks, dibucaine, and it's only a very small relief. I've taken some pain meds but by the time they wear off I'm right back to where I was. My dr is out of town so his fellow is calling me in nitroglycerin cream to help stop the spasming. Has anyone tried this before? He's also putting through a referral back to the colorectal surgeon.. Between this and my regular blockages, I'm soooo miserable Frowner Any info would be greatly appreciated. Thank you!

Margie
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Nitroglycerine (NTG) is pretty "old school" because of the terrible headaches it causes. Most docs prescribe nifedipine now. Same action (increasing local blood flow), but less likely to cause headaches, and if it does, they are generally less severe.

The pain and spasms are due to the fissures, which are in the anal canal, not the rectal cuff.

Oral pain meds are pretty much of no use in this case. If you can get them, some people get good relief from B&O suppositories (belladonna and opium). They can be difficult to get and probably will need to be special ordered.

If this does not improve with the topical treatment, then the next step is Botox injections or even sphincterotomy. But, I'd go with the Botox first, as it does the same thing as sphincterotomy, without the results possibly being permanent (wears off in about 3 months).

Jan Smiler
Thanks Jan. I had already picked up the Nitro Bid before I read your comment. I decided to give it a try and boy do I agree with everyone. It burned like crazy! It helped that others had mentioned that it burned for 5 minutes and then stopped because that's exactly what it did. I also was very lightheaded and found that I need to lay down immediately after. But, when I went to have a bowel movement a few hours later, it was the first time in years that I wasn't in pain afterwards. I was so shocked. So, I used it again today and I'll do my best to deal with the nasty headaches. After my dr gets back into town I'll ask about the nifedipine and the B&O suppositories. Thanks again!

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