questions on 2% diltiazem cream and Q tips

Hey everyone,

My CRS prescribed some 2% diltiazem cream and told me to apply it by putting a little cream on a Q tip pushed up inside the anal area. He said the cream was a 'muscle relaxant' that would help the area relax so that the blood could get to the wound site and make it heal up. He said putting the cream on the surface would do no good as it has to get up inside the anal area.

Question: What's the best way to apply this cream? Does the Q tip way to apply the cream sound right? I get worried that the Q tip will cause damage... although i try to be a gentle as possible. I also don't know how far to go in. The drugstore also gave me this plastic applicator that's like a small narrow funnel to put the cream in. The plastic seems like it would be hard and the gadget would be awkward. It would be a lot easier if I could just put the stuff on the surface.

Next question: Anyone had experience with 2% diltiazem cream? Does it help?

FINAL question: When I see blood on the tissue, I've been using a little triple antiseptic cream on the surface to moisten and ease the area. good idea/bad idea?

TIA for your help and thanks for all the support in this forum!!
You are the BEST!!!!

Hey Pat. I've been using this cream for maybe 2 weeks now. I;ve been using a qtip. Can't use the cream with yur fingers or you'll get worse side effects. Uhm, I usually use it around the edge, and then wait a moment until I relax, then take a semi painful plunge. I honestly am nooooot so sure if I've been seeing any results *sigh*

Hi Pat123,

It seems different CRSs have different opinions on how to apply the cream; inside or out. I went to the Lahey Clinic, was prescribed Nifedipine, also a calcium channel blocker like Diltiazem. I tried putting it inside, but the pain was too intense, so, as my CRS said apply it outside, this is what I continued with. I had mine compounded without lidocaine as have an allergy to that. You do not have to worry about having the cream on your finger. Only Nitro gives headaches if it comes into contact with your skin. 

What Diltiazem does is expand the blood vessels of the region,  which stops the spasms of the internal sphincter helping to heal the fissure. A good link to read about fissures is http://en.wikipedia.org/wiki/Anal_fissure. Diltiazem has helped quite a few people, but you have to persevere. Is it 2% or 0.2%?  The 0.2% is more common. Blood on your TP is common. I would not use anything except what your CRS prescribed. Be very gentle with yourself, wiping, etc.  

Sitz baths are good to relax the muscles there, Miralax to make your BMs soft, along with water and a suitable amount of fibre for the amount of food you're eating. 

Hope this helps!

Hey Bella... I'm in the same place you are. Not wanting to do more damage putting the stuff in.

The miralax has been helping, and my CRS said that you can use miralax long term if you need to.

Hang in there and maybe we'll see some results.

Thanks savaici!
Good information. I'm sure it's .2% as my case isn't severe.