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Fissures are so much worse with a j-pouch than with a colon! The last time I had them was over two years ago (with my colon) and the only way I got rid of them was as a nice little extra my first surgeon did during the colectomy. So I've never previously put prescribed medication on the affected area, but now I'm using Diltiazem 2%. The pharmacist said three times a day and after a bowel movement--so I'm putting it on well over three times a day. Does anyone else have experience with this? I am lucky enough to see my gastro in a couple weeks and my surgeon in a little less than a month so I can definitely get things figured out for sure then. I'm just wondering if anyone else has experienced any of these symptoms, with either a fissure or with using diltiazem ointment, for this painful interim period...
First of all, I am losing weight, because I'm afraid to eat--because I am afraid to poo. It always hurts and spasms, on top of which I have to lean forward/move around to completely evacuate my bowels so my *stuff* is everywhere. I feel so bad for my boyfriend, I never want him to clean the toilet. It takes me an extra five to ten minutes to get out of the bathroom because I'm wiping my crap off the wall. Which is the worst, because thanks to my awesome body I know have a weak stomach, so I either start to cry or get nauseous--or BOTH, of course!
After I put the ointment on it burns for like ten minutes and I get a headache. This ointment also interferes with me using soothing topical creams like Calmoseptine, my favorite. Cream and ointment don't mix, so instead of soothing menthol and calamine, I have stinging. Admittedly I have previously used calmoseptine instead of my medication because of all the pain I had down there. Having a painful bowel movement is bad enough, but on top of that I then apply stingy ointment to the "affected area" afterward!
Has anyone used Diltiazem before? Does it seem like it's helping more than hurting at this point? I could definitely get more fiber, but I am still taking extra fiber, it just doesn't seem to help anymore. Citrucel doesn't seem to do anything for me, but metamucil gives me lots of gas, which is also horribly painful with the fissure. Is this pain worth it?!
I read it can take up to two years to get rid of a fissure. I can't put up with this for two years! It's been about four weeks and I don't seem to be doing any better, though I haven't done a sitz bath in over a week either. Is there something else I should do or something I haven't tried? I appreciate any feedback, thank you!
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I doubt you are supposed to be using the diltiazem unlimited times a day. I would think maybe 4-6 times a day. Your pharmacist is assuming you have a colon and have a BM 1-2 times a day, maximum (remember, most fissures are associated with constpation). So, call the pharmacist and get clarification on maximum dosing.

I would also call your doctor and see about getting a prescrption for lidocaine ointment, or to get lidocine/diltiazem combined ointment. Lidocaine is a topical anesthetic and will help with that stinging and that shards of glass pain.

Hope that helps.

Jan Smiler
I would suggest a bidet. It helps to keep the area cleaner. I have used the product you mentioned....only tiny amounts right on the area or it will burn you all day. You can also ask for Valium...it helps with reactal spasms. Heating pads sessions also help. Relax your rectum. Holding it tight only makes things worse. I use a cream like zinc oxide or A&D to keep the area protected and not cause friction. Maybe take lomotil and sesson the number of times you go...the less you go the better. I also liked using Preperation H...it helped alot. Are you sure you don't have cuffitis?
MN Girl--what up?! A fellow Minnesotan! My best friend has lived in Duluth for five years now!
Anyway, I saw my surgeon recently and she said it looks a lot better and everything else looks great (pouch wise) but to keep in touch with them regarding the progress. I definitely need a pain med sometimes. After the bathroom, walking hurts--I'm gaining weight because all I can do is lie down and breathe through the embarrassing pain.
Slowing things down would be nice. I have recently added metamucil so everything is nice and formed and I may not go much less often, but I have a lot more productive trips when I go. Though I still think 4-6 (more on bad days) is too many times for a fissure to heal properly. But is that just a matter of eating less to go less? Because sometimes with metamucil and immodium combined I get a too-much-food feeling and all I can do is wait til I'm ready to go. Sometimes stretching in certain poses helps to move things along.
My doctor said it's just a bad fissure and to alternate the diltiazem with calmoseptine, which helps, but I still don't see this thing ever healing completely.

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