Creams / ointment for Anal Fissure Treatment (Part 1/5) 

Finally! The first video on treatment. Please let me know what you think!

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 ❤❤❤❤

Thank you doctor for taking the time to make these video's, it's very helpful

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!

I'm so glad I found your channel

So nice that you take the time to answer questions! These videos have been very helpful and comments as well.

Thank you Dr Chung beautiful explaination may God continue to give you the knowledge to help people out there. God bless you.

I watched all your videos it help a lot thank you very much doctor i love you

Doctor u r Soo positive n charming

Thank you Doctor for your help.

Thanks very much for your indepth suggestions

Thank god...We love you dr.

Thank you Doctor!

Thank you so much doc 🥰

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 🙏🏻

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.

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 ?

Thanku so much from Nepal 🇳🇵

Thank you sir

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!

Is there any cream that I can just pickup from local store ? Or will cbd cream also work?

Thank you

Thanks voor this video i use isosorbidedinitraat creme but i put the creme also inside, should i change and put the creme only uitside?

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!!

Hello what do you think about Rectogesic

Is it ok to use triad cream or medihoney?

Can one use aquaphor for 1st time tear?

Can i use 0.2% nitroglycerin ointment instead of diltiazem cream on the outside ?

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.

Wish you were my 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?

What do you think about Rectogesic

Thanks. What about PYLOOCAIN OINTMENT?

Will muscle relaxers help?

Hello! I've applied emla cream. Is it normal to feel burning after having applied it.

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

Hello dr in which dosis I can take oral diltiazem or nifedipine ?

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?

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

Hello Doctor is Bepanthen Cream good for that??

You say you dont want to stick anything in there, but you also recommend using finger to relax the muscles inside so im confused

What about silver sulfadiazine?

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

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.

GT N rectal ointment Does this work also Dr

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.

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

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.

Can these creams make our bums dependent on them? Like will you always have to use these creams for future ones to heal?

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 a fantastic video yet again. Dr Chun is an absolute champion :D This is definitely such an important thing to know and one which gets overlooked when trying to heal not only a fissure, but many different types of pain around the body. Keep it up

Sir ointment should be applied in sitting position or standing position?

Can you use Diltiazem 2 percent on reoccurring fissures. Like if it was fully healed, and it came back.

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

Is there a supply of that ointment here in Philippines?

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.

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!

How about the Pranicura that you also recommended? I've been using it for about a week! It's somewhat soothing!

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.

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

I have been through my surgery,Is it safe if diltiazem is applied on cut?

What about Nifedifine ??

Doc, my doctor prescribed Diltiazen 2% with Lidoca 3% , is this good? Or should it be stronger? Thank you so much!!

Should nifedipine / lidocaine combo be applied like diltiazem?

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

Dr. Chung, will Hydrocortisone cream cause any negative effects? I find it's the only thing that eases the pain.

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.

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

Hi Doctor, I was prescribed a hydrocortisone + cinchocaine hydrochloride cream and suppository to use for a fissure. My doctor is experienced and seems great, but all personal experiences I have read online say that hydrocortisone thinned their skin and made their fissure worse, sometimes even turning chronic as a result. Should I use this treatment?

Can u suggest some ointment for perianal abscess ??

Diltiazem as medication is heavy in my oppinion. I tried it as first medication but it gave me horrible dizziness due to severe blood pressure drops.

Hi Doctor, thanks for the video! My doctor gave me a cream with "Nifedipine". Is that also fine?

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

Would you say those tips re also good for nifedipine?

Hello dr. Chung, thank you for your videos! I have had symptoms for three weeks now, my stool is soft and I am taking sits baths regularly. I am abroad and because of insurance issues I can only go to the pharmacist. He advised me to use proctosedyl; I didn't hear you mention it in this video, but is this okay for anal fissures as well?

finally he talk about anal fissure, thank you dr. chung

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.

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.

Hi Doctor... how long should we use the cream once the fissure starts to heal? thank you!

Hey Dr. Chung! Your videos are absolutely amazing. My daughter’s fissure began after starting Accutane for acne. We’ve read all the numerous side effects, but anal fissures was not listed. Since Accutane causes dry, chapped, and cracked lips - could it not do the same to the back end? Thanks!

Hello Dr Chung. I Have just discovered you. I have had an anal fissure for over 2 years since spinal surgery. After 4 doctors and I colon surgeon misdiagnosing me I eventually saw a surgeon who found my fissure. He prescribed Diltiazem 2% for 8 weeks. After 4 weeks I developed the most awful irritation that progressed to all areas down below. I then developed urticaria all over my upper body. I have never had such a bad reaction from any medication before!? Can you suggest another cream that could help heal me please. I live in the UK.

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

Ive been given prednisolone ointment, is that good?

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?

What about preparation h with lidocaine until I can see my Dr.

Do you have a suggestion where to buy diltiazem ointment online and have it delivered to other countries?thank you

You're the best. Thanks for this. Any reason why you recommend diltiazem over nifedipine? My doc wrote prescription for nifedipine, but i have to go to some random pharmacy ive never heard of, 40 min away from me, that doesn't take my insurance. When i asked why not just write me a prescription for something at Walgreens my insurance would cover, the assistant went on like a 5 min sales pitch rant and said heres a 5 doller off coupon. Sketchy. Got the vibe my docs office might be quacks, but idk🤷 I have doc trust issues. Is this really better than something at a real pharmacy covered by insurance or does this mostly just make them more money..life...😣

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

Sir plz vedio fistula teratment and crem and tblet plz

My CRS is so insensitive…:(

Dr Chung I am at the end of my wits. I asked my doctor for the diltiazem and nifedipini. They only have it as tablets. Not as an ointment. I am so mad right now because I refuse to operate but I feel like im losing all hope now

Doctor gave me isosorbide dinitrate for anal fissure, is that good or should I change cream.

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.

Can we substitute these creams with GTN cream?

Hi Dr. Chung, I was prescribed Diltiazam which caused extreme rash. Is it a common side effect? Is there any way to avoid it and still use diltiazam as treatment?

Sir iam suffering from chronic fissure since 2 months & i have a pain & burning sensation a lot iam using anobliss cream & i will not getting relief from that so what i have to do for this problem it would not heal with out surgery give me suggestion to overcome this problem

last question doctor can I still go through the hot sits bath i have stage 4 I need to have an operation but I don't want the pain to go away before now come back again because of my ugly lifestyle of eating

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?

Hello doctor If not healing what is the maximum time that diltiazem cream can be used? 6 months, 9 months?

Hi,is it safe during breastfeeding