Diltiazem hydrochloride 2% cream or Lidocaine for fissure?

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ocstacy
Posts: 264
Joined: Mon Jun 19, 2017 11:29 pm
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Diltiazem hydrochloride 2% cream or Lidocaine for fissure?

Postby ocstacy » Wed Oct 03, 2018 12:23 am

Hi all,

Has anyone used Lidocaine or Diltiazem hydrochloride 2% cream for rectal fissure? My mom has been using the Diltiazem hydrochloride 2% cream for about two months now, and she still has that burning pain. So I was thinking if the dr. should prescribe her Lidocaine. Has anyone used this before? She is only 3 months shy of post recovery from an ileo reversal. With her age, I know it will take like 6 months to maybe 1 year to recover. I just hate seeing her in so much pain (like bouncing up and down like a chimpanzee cause it hurts) the expression on her face looks so painful. She is taking Tylenol with coating for pain, Aquaphor for comfort, and that Diltiazem. I wanted her to try the A&D and now possibly Lidocaine. What has helped you with your recovery pain with fissures. She has been taking immodium, metamucil, I am exhausted and running out of options. :? Any suggestions or advice please :?: ?
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

Ron50
Posts: 699
Joined: Fri Feb 10, 2006 7:04 pm

Re: Diltiazem hydrochloride 2% cream or Lidocaine for fissure?

Postby Ron50 » Wed Oct 03, 2018 1:08 am

Hi Ocstacy,
I use ditiazem daily but I use it for blood pressure control and also because it allows me to use lesser doses of cyclosporine which I take for nephrotic syndrome of the kidneys. Diltiazem is licensed for treatment of hypertension and angina. It appears it is also used in a gel or ointment as an unlicensed drug to treat anal fissures. the literature I read said that it appears to have some effect in treating fissures but it said you have to be aware of any allergies to diltiazem and also be a little wary if the person being treated is on any other form of blood pressure meds. I have had problems with bleeding hemmaroids over the years and got relief with proctocedyl ointment. Ron.
dx 1/98
st 3 c 6 nodes
48 sessions 5Fu/levamisole
no recurrence cea <.5
numerous l/t side effects of chemo

zephyr
Posts: 363
Joined: Thu Aug 18, 2016 7:31 am

Re: Diltiazem hydrochloride 2% cream or Lidocaine for fissure?

Postby zephyr » Wed Oct 03, 2018 7:18 am

Oh boy do I remember THAT episode. You feel like you’re passing broken shards of glass. My husband could hear me cry out from the other side of the house. Ok, it’s a small house, but still.

My GI doc gave me the Diltiazem (let’s just call it D cream ok?). It did not help me. Then I had a follow up with my surgeon and he gave me D cream with lidocaine also in it. I had to get it at a compounding pharmacy and insurance wouldn’t cover it. It ran me $50. Here’s the trick though that the surgeon stressed: if you don’t push it up one knuckle’s worth, it won’t work. It will not be easy at first but it will get better. At least that was my experience. My surgeon also prescribed Anusol HC (something like that) suppositories. I’m sorry I can’t be more precise but I’m not in my hometown where I could look it up. If you ask your doc, he/she should be able to figure it out. (Buy the 2 box supply of plastic gloves at Costco; your mother will go through them.) At night, I often rubbed a little of the cream on the suppository to make it easier to insert. Don’t know if that was a good idea but it felt better physically and I did get better.

I don’t remember how long it took to clear up but it was not, not, not months. Maybe 3 weeks but the pain level decreased very soon after I started and got better every day. My best wishes to your Mom. It’s an awful experience.

Good luck.
Last edited by zephyr on Wed Oct 03, 2018 7:44 am, edited 2 times in total.
Nov-2009 Early stage CRC, routine colonoscopy
2010-2014 F/U colonoscopies, all clear
Jun-2016 CRC during F/U colonoscopy, surgery, Stage 4, KRAS, MSS
Aug-2016-May-2018 Folfox, 5FU, Folfiri & Avastin
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Mar-2021 Forfiri/Avastin
Mar-2022 Ablation & Thoracotomy
Feb-2023 Folfiri & Avastin
Nov-2023 Xeloda & Avastin

zephyr
Posts: 363
Joined: Thu Aug 18, 2016 7:31 am

Re: Diltiazem hydrochloride 2% cream or Lidocaine for fissure?

Postby zephyr » Wed Oct 03, 2018 7:39 am

A couple more things I remembered ... A&D helped me protect the inflamed skin to keep the burning from getting worse. My aunt bought me these hemorrhoid ice packs and they also helped:

https://www.amazon.com/gp/aw/d/B01E5NP354/ref=mp_s_a_1_3_a_it?ie=UTF8&qid=1538570109&sr=8-3&keywords=hemorrhoid+ice+wedge&dpPl=1&dpID=41urit14-EL&ref=plSrch

I put them in a plastic glove and then placed them between the cheeks. Quite soothing.
Nov-2009 Early stage CRC, routine colonoscopy
2010-2014 F/U colonoscopies, all clear
Jun-2016 CRC during F/U colonoscopy, surgery, Stage 4, KRAS, MSS
Aug-2016-May-2018 Folfox, 5FU, Folfiri & Avastin
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Mar-2021 Forfiri/Avastin
Mar-2022 Ablation & Thoracotomy
Feb-2023 Folfiri & Avastin
Nov-2023 Xeloda & Avastin

stevieb
Posts: 410
Joined: Sat Feb 09, 2013 12:26 am

Re: Diltiazem hydrochloride 2% cream or Lidocaine for fissure?

Postby stevieb » Wed Oct 03, 2018 9:36 am

I tried every cream possible, nothing helped and it is extremely painful (I considered getting a permanent colostomy if I had too!). MDA did a botox injection to the muscles surrounding the rectum and got immediate relief and been good ever since.
Dx age 33
12/19/12 Stage IV liver/lung
1/14-2/28/13 Folfox
3/27/13 rectal/lung rst; temp ileo
7/11/13 liver res/ileo rev
9/30/13 - Folfox
11/13,2/21 NED
3/14 lung recur;6/16-VATS
7/14 5 bi lung mets
10&11/15 laser lung surg
2015 Colondar Model
12/15 5 lung met-folfiri
5/15 NED
11/15 2 lung mets; cryoablation
1/4/17 2 lung mets; cryoablation
NED as of 1/23/17


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