# Diltiazem cream



## Aidara (May 9, 2014)

Hello everyone, I finally got my defecography test. I will find out my full diagnosis on the 3rd of December when I see my colorectal surgeon. However, I was told during the test, that my anal muscles are pretty tight and that is preventing my anal fissure to heal and gives me incomplete evacuation. Then I finally understood why I have such a relief when using diltiazem cream. It works miracle for me! My surgeon prescribed me this cream twice. First time 6 weeks course last year. Second time 6 weeks course 2 months ago. I can't get in touch with my surgeon. His secretary said to contact my gp. I desperately need this cream in the meantime of waiting for my appointment (my symptoms are severe). GP told me that he can only prescribe it for 2 weeks as it is dangerous medicine to use for a long period of time. Do you know what are the side effects of prolonged use of diltiazem cream? Has anybody used it for a longer period of time then 6 weeks? Thanks a lot.


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## annie7 (Aug 16, 2002)

Aidara---i'm so sorry you're having problems and can't get in touch with your surgeon.

i've never used diltiazem cream, so unfortunately can't give you any further info on that...

i do have a couple of suggestions for helping you to relax your pelvic floor and anal muscles....

have you tried a sitz bath? that can help relax those muscles and also can help relieve anal fissure discomfort and promote healing. A sitz bath is soaking the anal area in plain warm - not hot - water for 15-20 minutes several times a day. you can either sit in a tub of warm water at hip level or higher if you wish or buy a sitz bath that sits on your toilet seat. i've done this using the latter method and it really does help relax those tight muscles. i was surprised at how well it works. plus it feels good. just don't make the water too hot.

here's a link for that. it's under "treatment".

http://gicare.com/diseases/anal-fissure/

you can also try to do those pelvic floor muscle relaxing exercises i posted earlier--the gentle 'squeeze and release' one etc...

i do hope you get some answers to your post here from people who've used the cream. good luck with everything...hope you can find some relief.


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## Aidara (May 9, 2014)

Thank you Annie. I have heard about sitz bath, but never tried them. I suppose I should give it a go. I checked the price, it is not too expensive to buy on ebay.

I also hope that there is people who has experience with Diltiazem cream. I am just wondering - why it is not prescribed for someone with anismus if it so effective in relaxing tight muscles? At least as a temporary treatment..


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## annie7 (Aug 16, 2002)

i bought my sitz bath at the local drug store--didn't have to order it online.

i don't know but just guessing here that maybe the reason why they don't prescribe diltiazem cream specifically for anismus is because there are other things for that purpose--maybe without so many side effects----such as valium rectal suppositories, baclofen rectal suppositories and various combinations of both these meds and others in suppository form that will help relax these muscles. maybe doctors just prefer to use these instead of diltiazem cream...maybe safer, etc?

i've also read of people being prescribed nitroglycerin cream to help relax tight anal muscles.

a few women have even told me that oral valium helped relax their anal and pelvic floor muscles.

of course all these meds have different side effects and may or may not work for everyone....the nitro cream can mess with heart rhythm.

and of course it's just safer and better in the long term if one learns to relax those muscles naturally, without using meds, by using biofeedback and also the exercises i mentioned. the exercises are quite helpful if done regularly.

have you read the book " headache in the pelvis" ? it's available on amazon. a lot of women with pfd have said it's a great book--very helpful--lots of tips and techniques for relaxing those muscles...


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## Aidara (May 9, 2014)

Annie, thank you so much! I am going to check for sitz bath at my local drug stores too, so that I don't need to wait it coming by post. I am glad that there is other medications to relax anal muscles, it means there is a hope. And I am getting the book you recommended, I am sure I will find something useful in it. I am so desperate to feel better that I know I will be committed enough to do those exercises.

Annie, you seem to be so knowledgeable, I really admire that. Thanks a lot for your advice, I find it really helpful.

One more thing, I can't stop thinking that if my surgeon decides to do spincherotomy for my fissure, wouldn't it also help with my tight muscles in general? I can't find any information confirming that. And if that helps, why people who have anismus , but don't suffer from anal fissures are not offered this kind of surgery to help relax their muscles? What are your thoughts on this, Annie?


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## annie7 (Aug 16, 2002)

i think it may be because anismus -- which is also known as pelvic floor dyssynergia, pelvic floor dysfunction and paradoxical puborectalis contraction---refers to a condition in which the external anal sphincter and the puborectalis muscle contracts rather than relaxes during an attempted bowel movement. so it's not just about the tight anal sphincter not working right but also the pelvic floor muscles which don't relax and coordinate properly. a spincterotomy cuts the internal sphincter muscle which temporarily weakens it but in my reading i don't see that the surgery has any effect on the pelvic floor muscles as far as having a bm is concerned. i haven't read anything to support this. i have read that the surgery can have a temporary side effect of incontinence but that's not really what you're after when learning how to relax and coordinate the pelvic floor muscles. and this is all just my guess...i'm sure there's a good reason why it isn't recommended for those of us with anismus.

that's a good question to ask your surgeon, though. he's the expert--he would be able to answer it.

doing the exercises is helpful in teaching you and your muscles what "relaxed" feels like. and then periodically throughout the day remind yourself to check your muscles to see/feel if they are tense and do a gentle squeeze and release to relax them--it's something to kind of work at all day long--to keep those muscles as relaxed as possible.

oh yes--i do know what you mean about being desperate to feel better. that's why i went to biofeedback and also bought my home biofeedback machine and have been working so hard at it. at the very least, i don't want to get worse...


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## Aidara (May 9, 2014)

Thanks Annie, I still don't know for sure if the problem is with my spincher or with my pelvic muscles or both. The doctor who was doing defecatory prctogram didn't want to share too much information with me as she said it has to be discussed with my surgeon combining results with anal manometry.

However, I keep very encouraged by you. You have so many conditions and you keep trying things and stay positive. Thanks to you I also have some new things to try. Thank you Annie and take care of yourself.


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## annie7 (Aug 16, 2002)

oh thanks, Aidara--







.

yes, that will be good when you have your appointment with your surgeon to discuss all the test results, get your diagnoses, have your questions answered and finally get a treatment plan. it's been such a long road for you. but despite it all, you persevered, you didn't give up and now you're finally on your way to some answers. good for you!

and yes, you're right--we never give up!







take good care, annie xx


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