Paul Sylvester :: Consultant Colorectal Surgeon
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0117 973 4111 /
Paul Sylvester :: Consultant Colorectal Surgeon
treatments - anal fissure Diltiazem treatment

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What is an anal fissure?

  • An anal fissure is a small tear in the lining of the anus (back passage) that can cause pain, bleeding and itching.

What causes anal fissures?

  • There are a number of causes of anal fissure, including:
  • :: Constipation – a hard, dry bowel movement;
  • :: Diarrhoea.


  • You have been prescribed a medication called Diltiazem cream.
  • This causes the muscles around the anus to relax, so that the fissure can heal and it is easier to have your bowels open. This treatment needs to be carried out for approximately 8-12 weeks.
  • Avoid getting constipated by eating a high fibre diet and drinking plenty of fluids.

How to apply the Diltiazem cream?

  • Using your finger, rub a small ‘pea sized’ amount of cream around the anal sphincter (the opening of the back passage).
  • Do not put cream inside the anus.
  • Apply the cream twice a day.

Common side effects of using Diltiazem cream

  • The most common side effect of using Diltiazem cream is a headache. If you should experience headaches it is worth carrying on with treatment as the headaches often disappear after about a week.
  • It is also important to wash your hands thoroughly after each application.

Follow up

  • You will be asked to come back to clinic in approximately 2 –3 months for a check up appointment.


  • Keep stools soft by eating a high fibre diet (brown bread, cereals and fresh fruit and  vegetables) and by drinking plenty of water. Aim for 6-8 glasses a day.
  • Avoid excess tea and coffee.
  • Always go to the toilet when you feel the urge.
  • Wash around the anal area after each defecation (bowel movement).


Spire Bristol Hospital The Glen, Redland Hill, Durdham Down, Bristol BS6 6UT
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