Creams / ointment for Anal Fissure Treatment (Part 1/5)
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- เผยแพร่เมื่อ 9 ก.พ. 2025
- Creams / ointment for Anal Fissure Treatment (Part 1/5).
🌟 Pranicura cream - hemorrhoids, anal fissure, anal itching treatment:
www.pranicura.com
😷 Dr. Chung is offering 💻 video consultations to everyone! This is Your time to tell your story and give additional information to help Dr. Chung give some recommendations to help you with your bottom end issues.
If interested, please email: YourFriendlyProctologist@gmail.com
❤️ I wanted to provide a place where you can easily gather supplies that will help you to better deal and heal your problem. I really appreciate you clicking on the links. Your support will help to grow this channel!
Stool softening:
Colace stool softener (100ct): cutt.ly/PTgUQJy
Colace stool softener (400ct): cutt.ly/4TgxpkF
Miralax laxative powder: cutt.ly/HTgURTC
Skin care:
Desitin barrier cream: cutt.ly/aTgUPQM
Calmoseptine barrier cream: cutt.ly/TTgUHlb
Dove hypoallergenic liquid soap: cutt.ly/2TgU1G3
Moist wipes:
Honest baby wipes: cutt.ly/tTgUNsl
Hemorrhoid care:
PreparationH cream max strength: cutt.ly/NTgUZit
Tucks pads: cutt.ly/NTgUXH1
PreparationH with lidocaine: cutt.ly/bTgUVbX
Recticare 5% cream: cutt.ly/yTgIeh1
Wound care supplies:
4x4 gauze pads: cutt.ly/tTgU7sx
Paper tape for skin: cutt.ly/fTgIqp6
Blue disposable underpad: cutt.ly/2TgIVzE
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DISCLAIMER: This video is purely educational and does not constitute medical advice. The content of this video is my personal opinion and not that of my employer(s). Use of this information is at your own risk. Albert Chung, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of the information contained in this video including but not limited to economic loss, injury, illness, or death.
Finally! The first video on treatment. Please let me know what you think!
Can you get this prescription in Canada Diltiazem
@@ronkuenle8094 I am from Canada and yes u will have to request your family doctor for it. Not available in Shoppers Durgmart as this medicine has to be compounded by a pharmacy that do their own mixing. My doctor wrote it for me and i took the prescription to Shoppers, they said that they don't do compounding but they did refer me to another pharmacy that did and i was able to get mine. It does relaxes your anal muscle as Dr Chung said and helps fissures to heal.
I can't thank you enough. My Doc was about to do the Botox and scraping of the fissure. I resumed the dilthazem cream.. problem solved. No pain. Like antibiotics... it's vital to continue the cream even after the symptoms subside. My Pharmacist says I can continue the cream for up to 6 months. Beats the heck out of risking incontinence.
@@georgesmith4446 I'm with you completely!
Thank you so much doctor. It means we can use this ointment for 6 months
Life is so beautiful for having people like you doctor Chung. You really make me feel so much more confident about my fissure will definitely go away ❤❤❤❤
At this point i have watched several of your videos, and once again I cannot express enough as to how grateful i am for your informative videos. I have been suffering from a fissure for six months, and i honestly believe that if i had searched, and come across your videos earlier that i would be completely healed by now.
Anyways to start from the beginning. Initially I saw as GP and got referred to a proctologist. I thought things were going to improve dramatically, and at first it did, however there were two things that went wrong.
Firstly this doctor (and his staff) instructed me to apply the cream into my rectum, recommending that a pea sized amount on my finger be inserted up to my second / third knuckle. This is in drastic contrast to your instructions of not inserting anything, finger or cream, into your body. Instinctively i have thought that this was counter productive, and given that the fissure needs to heal, applying ointment inside 3 times a day simply irritates the fissure further and impedes the healing process. Now that I know to only apply a very tiny amount externally (as you instructed), that alone will help with the healing process.
The second thing i wanted to mention was that this doctor initially prescribed me 2% Diltiazem and 5% Lidocaine cream, suspended in vaseline (prepared at a compounding pharmacy). I applied this 3 times a day religiously, and the Dr even told me I could not over apply it, so I over-applied (much more than a pea sized amount) . What ensued was a serious reaction of my outer bum skin to this medication. The reaction of my bum skin (externally) was almost horrific; it looked like I had a serious fungal infection, with red, irritated, incredibly itchy blistering skin that even bled. In addition my internal skin / lining felt incredibly sore. Since I did not have a follow up appointment for a few weeks I spoke to an RN, and she told me to just keep using what the Dr prescribed, suggesting that i was wiping too hard and irritating my skin. Eventually I went back to the pharmacist that filled my prescription, and between that conversation and looking up the side effects of these medications, I realized that i had to stop using it immediately. Five days after I stopped the medication my skin (externally) had cleared, but internally I was still very sore. To this day I think internally I not only had to deal with the fissure, but also had to now heal from the internal blistering (although I couldn’t see that). That was almost 4 weeks ago, and all i can say is it's been a crazy (and very unpleasant) experience.
When my follow up appointment finally came, I told the Dr what had happened, and I suggested i needed a different prescription. He then prescribed me a 0.2% Nifedipine and 1% Lidocaine cream. Of course I was applying that internally as well until I watched this video. Honestly my body was rejecting internal application even before I watched this video, so again I’m super grateful for your informative videos. I do want to say that I believe I am also having a side effect from this new medication as well, but its totally different; what i am noticing is like a 'buzzing' sensation in my left lower leg whenever I apply the cream. I did ask the Dr about this, and he did not think it was related to the medication, but I did want to mention it in case others might be experiencing the same thing.
The last thing i wanted to say or ask is do you do virtual consultations? I'm from Canada and I was wondering if a paid option existed for those that cannot see you in person.
Thank you,
Clayton
PS - I'm just wondering why not use polysporin ?
Thank you for being a part of this channel! I appreciate your feedback and story. I have opened video consultations to anyone interested. please email: yourfriendlyproctologist@gmail.com for all the details.
man how are you doing now?? plz tell me if diltiazem cream help and in how many days did u heal?? i am an 18year old student suffering from fissures which heal in like 7-8 days but come back within 2-3 weeks... im sick and tired of this and 2 days ago a doctor had to check my bottom end and inseted his whole finger there which has caused my fissure's healing process to reduce a little bit... plz tell me if its helpful to use this diltiazem cream??
@@kaushikrayadurga1592 for me that cream made things worse due to my skins reaction to it. I’m doing better but still some lingering issues
Thank you so much for your videos. They are really reassuring and positive & giving me hope I can get through this horrible painful thing that has taken over my life!
How r u now?? plzz rplyy
Amazing. Thank you 🙏🏻 hello from Liverpool. I have been having this problem almost 5 moths and I had first sigmoidoscopy and colonoscopy . Endoscopist told me its hemoroids but when I see today specialist I have been told its possible chronic fissure and am having emergency botox treatment as am a heart attack patient ( recently) and sm hoping this goes away as this is been absolutely hell of 5 months of constant paid which I can NOT describe. Hope no one ever has to go through what I experienced last 5 months. Mr Chung thank you. God bless you Dr 🙏🏻
Wow, what a story. Wish you the best!
I can relate it . I had COVID and took some antibiotics along with 7 days no physical exercise which led to hard stool and then fissure. Now been 2 plus months
No cure yet.
@@nitinkmaurya same thing happened to me after I had covid, what are you using treatments, meds?
@@kavitasankar9252 Just taking care of food and isapgol bowel regulator with more fruiyand vegetable
Also diltiazem based gel for healing it.
i hate those one hour or three hours if sleep as the spasms and needle like pokes keep me up .
You say you dont want to stick anything in there, but you also recommend using finger to relax the muscles inside so im confused
I had my surgery 1 week ago, I'd say it's the best decision I took. The surgery I had was laser sphincterotomy
It had bled a lot in the first 2 days, after that there was a lot of discharge. But it has been nearly painless if I am to be honest with you. Even during bowel movement. I'm actually on day 7 now. To anyone who is afraid of surgery, trust me it is the best option. My anal fissures reached a point where they'd hurt up to 2 days after passing a bowel movement. I was unable to walk without difficulties, medicines stopped working as well. I couldn't live a normal life. So before you get to that stage. Consider having surgery.
Hi, how is it now?
How are you now need your review
how r u now dear?
How it your recovery going now can you share with us please!
Thank you for this video!!!! I was putting my cream all wrong and wondering why i wasnt healing well. I didnt know it just goes outside. Thank you!!
Hi how did you go with the cream? I am on day one and as oppose to the instructions on the box i am applying externally as well
@@haydenaktay417 its all good. Just give it time for it to work. Good luck!
Thank you Dr Chung beautiful explaination may God continue to give you the knowledge to help people out there. God bless you.
Thank you doctor for taking the time to make these video's, it's very helpful
Today I got 0.2 nifedipine oinment, as the doctor was explaining th3 medice I knew you talked about as well, so I thank you for just talking about it in general
Did it work?
Did you have to put it in your butt or just on the outside ?
@andrewkruger5986 no i don't think it worked for me, but I did recover after 6 months،
I'm so glad I found your channel
Hi doctor i have the fissure problem during 5 months (it is the first time),i want to heal my fissure crack through the onintment(your suggestion),my fissure can heal🥺?it will take how many months ?plz reply
6 weeks
Doctor u r Soo positive n charming
How long the ointment should be used for? Thanks
I love you ,, you just removed my fears about how put it inside
Sir ointment should be applied in sitting position or standing position?
Is it ok to use triad cream or medihoney?
So nice that you take the time to answer questions! These videos have been very helpful and comments as well.
Glad it was helpful!
Thanks voor this video i use isosorbidedinitraat creme but i put the creme also inside, should i change and put the creme only uitside?
I watched all your videos it help a lot thank you very much doctor i love you
Ive been given prednisolone ointment, is that good?
I would discuss this with the doctor that gave the medication to you.
Thank you for existing
Can these creams make our bums dependent on them? Like will you always have to use these creams for future ones to heal?
now i am using autolyse ointment from tonight,just got recommended from the doctor... what fo you say too doctor chang
You are right about the nitroglycerin. It gives a really bad headache and makes one feel dizzy. I don’t have a choice as that’s what my doctor prescribed. I wish he had prescribed diltiazem.
I wish you were in my neck of the woods so I Could see you. My doctor is kind of useless. I don’t think he is giving my issue as much attention as I would like. He brushes off my pain
Yes, many people experience the same side effects as you. Perhaps you can ask for the medication based on your research?
I'm so sorry to hear about this! What an awful feeling. Perhaps a second opinion with another specialist might be the next step? I wish you the best.
Will muscle relaxers help?
Hello what do you think about Rectogesic
Can u suggest some ointment for perianal abscess ??
Thank you for your valuable videos
I want to ask a question is there other alternative to diltiazem ointment because it doesn't found in my country
Is there a supply of that ointment here in Philippines?
What about nitroglycerin..my doctor gave me that and when I use it I get a bad headache
How long one needs to apply these creams? Doctor please tell. Can we apply these for as long as one year?
It depends on your condition. Please see your specialist.
Thank god...We love you dr.
After we heal the chronic fissure do we stop these creams/ointments? Or for how long after we heal do we discontinue use of these ointments? Or do we just have to apply these creams for life?
Same question
Same.
Hi, if you have time, can you make a video about all the stuff we can find in the drugstores. Witch hazel, mineral oil, lax, stool softener, diaper cream, epson salt etc. What help and what doesnt. People are saying stuff and we dont know what to believe/mix.
This is an excellent idea and I have been working on figuring out a way to organize the series. Thanks for commenting!
What an amazing idea!
Hi,is it safe during breastfeeding
It's 3am, and my father is screaming every time he poos, Giving him immodium to stop diarhea but takes a while to work,
I had a debridement and bottox under anaesthetic - painful recovery over several weeks but definitely healed the fissure. Botox relaxes the sphincter and allows blood flow to heal the fissure.
Hi Doc how about faktu? Which is better for fissure? I’m experiencing pain 5/10 😢
Do you have a suggestion where to buy diltiazem ointment online and have it delivered to other countries?thank you
Im sorry, its by prescription here in the US.
Crema gel is available in india. It has diltiazem
Thanks very much for your indepth suggestions
Hello! I've applied emla cream. Is it normal to feel burning after having applied it.
Can one use aquaphor for 1st time tear?
doc how about the anonet neo actirag hownmany time to apply ang hownlong can i use this cream? im here in europe.thank you doc
Hi Doctor, thanks for the video! My doctor gave me a cream with "Nifedipine". Is that also fine?
Yep!
Doctor Chung, what is wrong with me? It feels like I have water just going through my sphincter. And it's been vibrating for over 2 months now. And I can't get a doctor for nothing to help me.
My body is breaking down on me, they gave me. Nitro Griffin but I have no one to do it for me or take care of me. I live here in Tampa, Florida. I meant so much pain my butt doctor dropped me. You said my stuff was too advanced for him. Help me
Hello dr in which dosis I can take oral diltiazem or nifedipine ?
Thank you very much Dr Chung for those videos , I would like to ask question please,
Can you explain how to use Glyceryl Trinitrate 0.4% And how many time/day, And can we use diltiazem cream at the same time.
Thank you.
Hi Doc!
Great video! I’m also using pranicura at the moment that relieves the symptoms thanx to you!
Quick question: Can you use the diltiazem at the same time as the pranicura?
Cheers Doc!
sure!
scheriproct? Can this be used?
Pls give an update on pranicura? I am using diltiazem with little to no results.. PAINNN
@@knowledgeseeker1548how r u now?
Hi doctor if i ll use it 4 times a day then in how much time my fissure will be healed…and how i ll know m putting it correctly
Thank you Doctor for your help.
I cant use Diltiazem because it causes intense irritation and soreness. The other cream is called Rectogesic where I live but it is the nitro cream. The side effect common with it is that it gives a headache and can cause dizziness. I have got used to it now and I just use a tiny blob twice a day when I get a flare up, it works fine. If the fissure is bad it can take about eight weeks to heal properly but I keep using it for about three months.
Can i use 0.2% nitroglycerin ointment instead of diltiazem cream on the outside ?
Dr. Chung, will Hydrocortisone cream cause any negative effects? I find it's the only thing that eases the pain.
You tried pranicura?
@@knowledgeseeker1548 I haven't. It's expensive and takes a while to get it from what I hear. If only they'd work with Amazon their sales would explode.
How about the Pranicura that you also recommended? I've been using it for about a week! It's somewhat soothing!
Pls tell me your pranicura update? I am using diltiazem with slow to almost no gains, been suffering from fissures 5 months now
Hi Doc, if you are still checking this video, can you please confirm that we are not needed to apply the ointment within 1 cm inside the anus, a lot of manuals say this method is only one.
Personally I think that applying it outside should also work but will like your confirmation that it can work this way even now
For how long after the fissure flares would you use it? I have the cream it works well but when I get a flare up I never know how long to keep taking it
Thank you pls what is the name of the crime pls.
Watch the video. Dr. Chung tells you the names of the 3 creams and two appear on the screen in text.
Hi Doctor... how long should we use the cream once the fissure starts to heal? thank you!
I recommend coordinating this with your specialist who can see your fissure.
Thanks. What about PYLOOCAIN OINTMENT?
Hello Dr. Chung!
Does it make any sense to use both during day: nifedipine (right after wake-up and before sleep), diltiazem (3 times during the day)? Does it help to keep this inner muscle relax?
Thank you!
Would you say those tips re also good for nifedipine?
Yes! I would definitely recommend the same tips.
I have been through my surgery,Is it safe if diltiazem is applied on cut?
Should nifedipine / lidocaine combo be applied like diltiazem?
It can!
GT N rectal ointment
Does this work also Dr
Thank you …i am from iraq and i going to be adoctor place i need books in medical to improve my languageand get more information..and i will so thank you if you help my
And i ask the God to blass you
I was prescribed hemo+ but it didn't do any good to the wound or the symptoms am suffering and i can't find any orher cremes better than this😩
@SushantGaikwad-eh6rd speak English please
Hello Dr. Chung. My doctor prescribed Diltiazem Hydrochloride 2% Cream. But the leaflet and his instructions said to apply it only twice a day. Does 4 times a day seem excessive to you and against the instruction manual? If you can kindly advise. Thanks.
I recommend all my patients use it 4 times a day.
@@yourfriendlyproctologist Thank you Dr. Chung. One more thing. You said just apply it on the outside, just a pea size application. Whereas my doctor said to insert it at least a cm inside the anus. He said that Diltiazem cream should reach the fissure. If you can please advise on this. Also, is it possible that the fissure itself may not be painful while defecating but the spinctre is going into spasm causing pain afterwards. This is the symptom I am facing. Thanks.
I have the same symptoms. After I put the cream on the spasms get worse. Those knife painful spasms are so awful I wish they would go away
@@taradawn6777 how are u now?
@@taradawn6777how r u now?
What about silver sulfadiazine?
Thank you so much doc 🥰
Dr. Chung thank you so much for your videos. One question doctor one morning i woke up with pain down there its like paper cut sharp pain ( i was not constipated , no diarrhea)specially in my perineum and my existing fissure started hurting so bad. I think it is because of some fungal infection or may be yeast. Can you please suggest me otc antifungal ointment. I just order pranicura . Is it safe to use pranicura in perineum area?
Thank you for your video, my pharmacy and doctor don't explain the details like " not putting too much" or "it doesn't have to go exactly on the fissure" as clearly as you did. They prescribed diltiazem and it's been a month since my colonoscopy and it's gotten slightly better. But still hoping for a solution.
i got prescribed nifedipine/lidocaine
i have a lump and the fissure is on it ., when i put the cream i only put it on the fissure and it burns for over an hour ., I'm guessing it's not supposed to go on the fissure lump because it irritates it maybe ., I'm not sure what should I do ., what's your opinion ?
thanks in advance
@@CarlosRodriguez-nh8gy hey man, ya im not 100% sure what the next step would be, my fissure hasn't completely healed so I followed up with my primary care doctor and shes sending me to another gastroenterologist. im hoping to find out whats wrong.
@@johnny4495how r u now johnny4495?
Dr Chung, for a few weeks now have being watching your videos you have help me so much more than the four doctors and the two consultants have seen over the last year of pain got question I would love you to answer
I don’t bleed and Really enjoy swimming is this ok
Swimming is fine to do.
Wish you were my doc !!
Thank you so much for saying so! You made my day!
Thank you Doctor!
DOC PLEASE HELP : When i apply diltiazem externally , it cause itching and little rash , because after applying it get spread more on outside , should i apply it little bit internally too
Where can l buy this cream?
Can get in Kuching, Sarawak?
For how many days we should use dilitazem?
I will depend on how long it takes for the fissure to heal. definitely keep using it until then. See your specialist for further guidance.
Hello doctor
If not healing what is the maximum time that diltiazem cream can be used? 6 months, 9 months?
diltiazem can be used for several months, but should be used under the guidance of a physician.
Hi Doctor Chung, you are my favourite in this difficult time where I am dealing with a painful fissure for last 4 weeks. Your videos are so informative and so helpful for all those who are suffering. I am currently using this cream, Diltiazem that you recommended using 4 times a day. Iam a bit skeptic of using it so many times as it’s a blood pressure medicine . Is it totally safe. I don’t have any other medical condition and my GP prescribed Diltiazem.
Did your fissure heal?
Is Rectiv good cream ?
I'm not a fan of it, it's just my opinion, of course.
Thank you for your quick answer, I will follow your tips I have a chronic fissure with a sentinel skin tag the doctor told me try creams first fiber diet ect if not I have to do the surgery I m from France and I live alone in the US
@@yourfriendlyproctologist are you in NY?
Thankyou Doc
hello Doctor, I was prescribed a Dilitazem ointment to heal the fissure. My specialists told me to insert the ointment inside while wearing a glove after examining the fissure. He didn't mention anything about applying it the way described in the video. Is it okay to use it in the inside area of the canal?
Same here how did u apply? Have you healed?
Hey dr. I recently went to a local doctor for blood in my stool. Upon him looking at my anus he said it was a fissure. He prescribed rectiv but its $700. I don't have any pain when going to the bathroom or even when not. I started taking a rutin powder i had on hand and I have not seen blood in 2 and a half days. If I don't have pain, do I need any rx for it to heal on its own? If so the local compounding pharmacy said they can mix diltiazem at 2% with lidocaine he did not say what percentage of lidocaine. What would you suggest? I am not in pain and I worry about side effects from any rx.
If I need it to heal what percentage of lidocaine?Thanks
Thanku so much from Nepal 🇳🇵
What about preparation h with lidocaine until I can see my Dr.
Doesn’t help one bit, tried it. Fissures are really intense!
Hello Doctor is Bepanthen Cream good for that??
Thank you
Doubt is it wont heal....2 year very smalm pain....during some tine a small dot blood........ is it non curable....
Now i gained courage to deal it
Hi doc,
Seeing your vedios are giving me hope and Clam my anxiety.
Before using Diltiazem ointment can you please clarify that will this ointment cause constipation?
Because I am easily constipated. Because of this I have chronic 2 fissure. The pain is hell. Is it safe for me to use it? Will it cause constipation?
What about Nifedifine ??
I am using that now for fissure. It works but give a very warm tingling sensation around the area, with is kinda concerning really. My directions say to put a pea size amount , but I think that may be too much???
Hello Dr. Chung. I need an advise. I was prescribed an ointment which has Cinchocaine Hydrochloride bp 5 mg, Hydrocortisone bp 5mg, Framycetin Sulphate bp 10 mg & Escullin Ph. Grade 10 mg for my fissure problem. He prescribes it for 14 days. But how long can I use it without any issues? Diltiazem is not available in my country.
Thank you.
So u have to use nitroglycerin or it would not heal
My preference is diltiazem. Yes, I believe this medication is necessary for anal fissures.
Thank you for all the information. I’ve been dealing with a fissure for 2 years. I tried all these creams. Currently using Rectiv. I was out with the kids at the park and I felt like I was going to pass out. Now I know why. I was also prescribed hydrocortisone suppositories. What are your opinion on them?
That happens more often on Rectiv. It's why I prefer diltiazem.
I recently got recticare. Would that help with a fissure? It’s 5% lidocaine. Anything OTC that can help me?
It certainly can.
@@yourfriendlyproctologist thank you for the information!
For fissure, I was prescribed ISMO 20 (used for the prevention of angina) to crush into powder and mix with amethocane cream which is a local anaesthetic. Is the ISMO correct? ChatGPT says it is not typically used topically
I can’t sit. My Dr just gave me this ointment that’s nitroglycerin with lidocaine but I feel like I’m still in so much pain. I have been taking stool softeners too but I feel like it’s not enough. Should I take a fiber supplement?
how r u now?
Can you use Diltiazem 2 percent on reoccurring fissures. Like if it was fully healed, and it came back.
Hey Doc, thanks a lot for the informative video, I have been battling with an anal fissure for like 2-3 Months now, I just got a new cream to use Nitroglycerin because diltiazem made me so itchy, and I also use Fiber supplements. I recently found out that I am Lactose and Histamine intolerant. My question is: Does my intolerance play a role in delaying the healing of the fissure? I say that because I think it is influencing my stool to come out inconsistent and hard at times as well as diarrhea.