Anal fissure: What helps it heal?

Hello - I am new to this group and would like to ask if any of you have tried red light therapy (infrared) to assist with healing? If so, did you feel that it was helpful as part of an overall conservative protocol for healing a chronic fissure?

I also have a question about using Botox on a 1x basis to settle down the spasms and give the fissure a better chance of healing. I did see in previous posts that Botox has been tried by some, but if anyone has recent experience, it would helpful to collect your thoughts. Additionally, will you please comment as how the Botox was administered? I have read about varying approaches (e.g., superficial around the outside of the sphincter muscle with a local anesthetic vs. injections higher/deeper into the muscle under general sedation).

I have been fully checked out by both a GI specialist and colorectal surgeon. I do not have any underlying conditions...just the fissure and associated spasms. Just trying to assess my options should I need to go beyond conservative measures to clear this up. Thanks so much!

50%r of people can heal them on their own without surgery. Hot sitz baths really helps. Yes, very painful and I feel for you. Keep your feet elevated when you can.

Hi Mikaylar - thank you for your response. I am on a conservative treatment path that includes sitz baths, a compounded ointment, pelvic floor therapy, and so on. Hoping very much to heal it without a surgical intervention. I'm scheduled for a recheck in October. In my case, I was initially misdiagnosed and I think the time lapse is what slowed down my healing. I will add more time w/feet elevated based on your suggestion! Thank you again.

What finally helped me after 2 surgeries and 14 years sitting on a donut was an anti-seizure medication for an unrelated matter. 2 weeks on Topamax and I was better. My pelvic therapist mentioned that she had heard of that. Well, why not mention it to me???

Hi there - completely agree. Thanks again. 🙂

@cahabagirl yes, Nifedipine compounded ointment is what healed my fissure - cost me around $70 because my government health plan didn’t cover it, but it was worth the out of pocket cost! It took six weeks of application three times a day.

I too developed constipation after my colonoscopy and had to remedy that first. That was why it took so long for the fissure to heal.

Hi Rashida - may I ask if your compounded ointment was Nifedipine only? Right now I am using a blended compounded ointment (hydrocortisone, lidocaine, nifedipine) 2x per day for six weeks. Then a recheck with my physician. Also, may I ask if you applied the Nifedipine externally only or also internally? I was told to only apply my ointment externally, but I've read elsewhere that others are told to apply internally as well. I'm still having spasms and am concerned those will impact healing (in a negative way). Any information you can share is most appreciated. Thank you!

I’m so sorry you are suffering like that. I’m on this forum because I had a colon re-section. I’ve recovered really well. (I’m now on the breast cancer forum as I have been diagnosed with breast cancer recently.)

I had terrible haemorrhoids before the surgery and the cream I was given, and worked quite well is, proctosedyl. It is a Rx and has 5% cortisone, which helps reduce the swelling. Maybe you could ask your doctor to prescribe it. I am in Canada, I know that can make a difference to availability. I hope you can try it, it sounds like you’re dealing with something terrible.

@ruth2019 the label just says “Nifedipine 0.2% ointment compound” so I don’t know if a compound means it is a combination of other drugs. It was made up in a compounding pharmacy. I applied it internally, using a finger cot three times a day plus after a bowel movement. The ointment came in a pump dispenser which I found very convenient.

Thank you so much for this additional info! Sounds like you had nifedipine only and it was prepared by a compounding pharmacy (mixed to order) vs. pre-packaged and sold by a non-compounding pharmacy (Walgreens, CVS, etc.). Mine is also compounded with the two additional components (hydrocortisone 2.5%, lidocaine 5%). The concentration of nifedipine in mine is the same as yours (0.2%). It's so encouraging that you had success. I'll call my physician's office w/an update next week and perhaps that will result in some adjustments based on my symptoms. Take care and thank you again.