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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
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Experience:  Board Certified Family Nurse Practitioner
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Hello, Embarassing problem hopefully someone can help. Just

Resolved Question:

Hello, Embarassing problem hopefully someone can help. Just been diagnosed as having a fissure which is very painful when use toilet. Doctor precribed me `xyloproct` but cannot remember his dosage advice. There is no instructions/recommendations in carton. How do i use and how much do i put in/on which i guess is next question, does it go in or on? Also feel like need to use toilet tonight but holding back from going because of pain.Is it wise to hold back? Is there anything natural that you could recommend before i use this treatment as unsure as to safety. Its been 2 long weeks! Many Thanks
Submitted: 7 years ago.
Category: Health
Expert:  Lisa, MSN, FNP-BC, CCRN replied 7 years ago.



Thank you for writing in today. Yes, fissures can be quite painful, especially when straining to have a bowel movement. First of all, about the medication, this medication, xyloproct, is actually a topical anesthetic and also a steroid. The lidocaine will help numb the pain. The hydrocortisone will help to reduce inflammation. As for the prescribed regimen for the medication, you should consider clarifying with your provider. Xyloproct is available in ointment for external application (thin layer) several times a day; however, it is also available per suppository and ointment with applicator for internal application. Internal application is not done as frequently as topical application. Depending on your fissure type, your provider made a recommendation specific to you, so I would recommend clarifying with that provider; however, you may be able to check with the pharmacy as well, since they may have a prescription on record. Also, just as a side note, if you do have issues with frequent straining, constipation, or diarrhea, you may need to talk with your provider about possible lifestyle modifications and treatment options. Irregular stooling can increase the risk of fissure formation. I hope this helps. If you have any additional questions or concerns, please let me know. Lisa

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Customer: replied 7 years ago.

Hi, Thanks for response although main questions are dosage and whether internal/external application req. Advising to ask my doctor defeats objective of using this service. Chris

Expert:  Lisa, MSN, FNP-BC, CCRN replied 7 years ago.

Hello, Chris;


Thank you for responding. The frequency of usage and whether or not the medication is to be applied externally or internally depends on your fissure. All fissures are not equal. They vary in size and also whether or not there is internal involvement; therefore, to make a specific recommendation, I would have to evaluate your fissure, which is impossible given the online format. I hope you understand. I'm sure your provider or pharmacist will be happy to clarify the specific prescribed usage, based on your specific fissure. Lisa