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Anal Fissure
I’ve been dealing with a recurrent anal fissure for the past 1.6 years. It tends to reoccur every 2 to 3 months, always at the 12 o’clock position. Until recently, I had been using Ayurvedic oil. For the past 4 months, I’ve been using Cremagel (diltiazem) at night and Smuth cream in the morning, applied internally with an applicator.
I eat healthy food and drink 2L of water.
Currently, my bowel movements are soft and regular. The fissure cut at the 12 o’clock position is no longer visible externally. My only remaining symptom is a mild burning sensation for about 5 minutes after passing stool. Please help me why this burning sensation is there after I'm done with motion?
I have a few questions:
1. Why do I still experience this burning sensation after bowel movements?
2. Is it safe to continue using Cremagel and Smuth cream long-term?
3. How long can I safely use these creams?
4. Are there any possible long-term side effects from continued use?
Answers (5)
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Hello. Hope you are healthy and healing. So, fissure has healed externally. But the burning sensation means, it can recur anytime soon. Even after one episode of hard stools. So always keep yourself hydrated(3-4L water on summer ) and take minimum 2 types of vegetables daily. Also add fruits daily.
Regarding your ointments, please use smuth till the burning sensation settles. There is no harm. Cremagel yu can skip.
And please daily take sitz bath twice. Yu can fint sitz bath tub online. Buy one and use it twice daily with mild warm water. It works wonders. It heals everything soon and also reduces pain instantly. It's very comforting.
Next Steps
dietary modification, sitz bath daily.
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When u depend on medicine for smooth motion u will not be able to be ok without using them.
Better have more fluids and food modification than the medicine
Nothing harm in taking cremafffin daily but in rare conditions it causes dehydration, volvulus conditions in elderly
Burning sensation may be due to small fissure or erosion over that area locally
Next Steps
Consult surgeon for proctoscopy
Health Tips
Have fibre rich diet, fluids banana guava papaya daily during nights
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A previous site of fissure is a potential site for another fissure. The burning sensation could be because of minor skin trauma while straining or you might have small external haemorrhoids - both will need clinical examination to confirm, but do not be worried. You just have to continue adequately hydrating yourself and taking enough fibre in your diet.
Diltiazem itself can cause burning sensation and irritation in a few individuals.
You can use both creams but it should not be necessary once you have normalised your bowel movements with your diet, exercise and hydration. There is no specific safe duration of use for those creams. They should be discontinued once the fissure heals.
Next Steps
It is advisable to reduce the use of creams and resort to lifestyle changes. Use them only when you need them.
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If the pain is minimal just stick to adequate water intake3L approx,high fibre diet,avoid junk n spicy food.
The cream is to just reduce pain.
If symptoms recur...better to consult a surgeon
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Hey. Hope you are doing well.
You fissure seems to have healed externally. But the internal mucosa tends to take longer to heal. Small nerve endings may be irritated while you move bowels due to stretch. It can take sometimes longer time to heal.
As per ur question of using medication, diltiazem is safe for long term local use.
Next Steps
Continue using diltiazem and do sitz bath before applying the ointment. I will suggest u do this thrice a day
Health Tips
Avoid spicy food and foods that may make ur stool hard
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.