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Suggest Medication For Anal Fissure

Posted on Tue, 21 Jun 2016

Question: I have been diagnosed with anal fissure and recommended the following by 2 separate doctors:

Doctor 1: Ceftum 500mg BD; Tiniba 500mg BD; Dolonex Rapid BD; Pantocid; Shield Ointment before stools and Metrogyl Gel after stools and lastly Softovac SF 2 spoons at bedtime.

Doctor 2: Sitz Bath; Lox 2% gel before stools; Cremafin 4 spoons at bedtime and SN15 Sos when pain

Csn you please advise why there is so much difference in prescription and which one should i follow?

Answered by Dr. Amit Jain (1 hour later)

Brief Answer:
go with 2nd doctor but also add nitroglycerine ointment

Detailed Answer:
Hello. Thanks for putting your query in hcm.

Basically the treatment of anal fissure involves following medicines:
1. A laxative which make stool soft. Like first doctor has prescribed softovac and 2 nd doctor prescribed syp cremaffin
2. Local ointment to relax anal sphincter and to reduce pain. First doctor prescibed shield ointment and 2 nd doctor prescribed lox ointment and both of them are for relieving pain

Sitz bath have added advantage and helps in relieving pain and fasten the healing of fissure

SN 15 tablet also fasten the healing of fissure

There is no need of antibiotics as first doctor has prescribed like tab ceftum and tab tiniba and local ointment in the form of metrogyl ointment

So I will suggest you to go for 2 nd doctor.
Few more things I want to add to it
1. Take lots of fruits and vegetables to increase fibre to make stool bulky
2. Add ointment containing nitroglycerine which will help in relaxation of anal sphincter which will relieve pain and fasten the healing. To be used before passing stool
3. Lox ointment for relieving should be used 4 to 5 times per day

I hope I have answered your query and this will help you. Wish you a good health

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Amit Jain (4 hours later)

Thanks doctor, just to provide some additional information that i was burning sensation for last 2 months approx but i was ignoring that thinking that it will go away itself. Is this the reason why 1st doctor prescribed antibiotics. As per your advise, i should use two ointments before passing stools 1) vox and 2) ointment containing nitroglycerine...and apply vox even after passing the stools i.e. 3-4 times a day. Did i understand you correctly?

Answered by Dr. Amit Jain (4 hours later)

Brief Answer:
if burning sensation is there then take oral antibiotcs alsi

Detailed Answer:
Welcome back. Yes this may be the reason why your first doctor has prescribed antibiotics. So if burning sensation is still there then you should oral antibiotics only

Yes you have understood clearly the method of using the ointments

Wish you a good health.

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Above answer was peer-reviewed by : Dr. Yogesh D