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Topical anesthetics, used in conjunction with steroid cream, can be used before a bowel movement to reduce pain caused by anal fissures.  Xylocaine, lidocaine, tetracaine, and pramoxine are topical anesthetics. While some anesthetics are available over the counter, many require a prescription. Ask your doctor for a recommendation and, if needed, a prescription for an anesthetic to treat your anal fissures.  Creams are applied gently on the rectal region before a bowel movement, with a clean paper towel or wipe. Some drug stores sell wipes specifically designed for applying such creams. A small amount of a steroid is often combined with creams and ointments. This helps reduce inflammation and numb some of the pain associated with bowel movements.  If using steroids alongside aesthetics, you should not use the medication for more than 2 weeks. Using steroids for a longer period can thin parts of the rectum, resulting in further trauma to the area. Your physician should be able to recommend a stool softener for you. This will help ease the pain and labor involved during bowel movements, giving fissures a chance to heal.  While stool softeners are generally available over the counter, you should ask your physician for a recommendation. If you are breastfeeding especially, you want to find a brand of softener that will not harm your baby.  Take stool softeners as directed on the medication's label. Only take the suggested dosage and be aware of any possible side effects. Talk to your physician if you experience any side effects. Combing stool softeners with home remedies, like drinking extra fluids and eating a high fiber diet, can help with anal fissures. Some ointments contain a muscle relaxant called nitroglycerin. Nitroglycerin can relax the sphincter muscles and reduce contractions and spams during bowel movements, and also help increase blood flow to the anus. This reduces the trauma around the rectal region, giving anal fissures the chance to heal.  Nitroglycerin should be applied using a q-tip. Apply a small amount of ointment to the q-tip and insert the cotton tip into the anus. Do not go farther than this, only inserting the cotton portion.  The concentration of nitroglycerin in ointments is relatively low, usually only around 0.2%. Topical use of nitroglycerin for treating anal fissures is considered safe while breastfeeding. Side effects do occasionally occur when using nitroglycerin. The most common side effect is a headache or lightheadedness.
Try topical anesthetics and steroids. Use stool softeners. Ask your doctor about nitroglycerin.