Hi doc. I am 40 years old make. I am suffering from anal fissure and have been prescribed pruvict 2 mg along with cremaffin plus 2 tablespoons twice. I have taken both these medicines for 1.5 months and fissure problem has improved. But lately I am suffering from indigestion and bloating. Namaste is there a possibility it was caused because of these two medicines. I have a very old history of peptic ulcer syndrome which was like 20 years ago. My question is does pruvict 2 or cremaffin plus can aggravate or worsen already cured peptic ulcer problem. Is it safe to take pruvict 2 along with cremaffin plus. Thanks.

Dr. Vijay Kumar SinghGeneral Surgeon14yrs exp

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Hi there! I understand this must be a difficult time for you. Anal fissures though a common occurrence can be very bothersome and require time to heal. Let's see how I can be of help. * if you have been prescribed pruvict (prucalopride) means you are suffering with chronic constipation and have already had trials with the usual laxatives that did not work for you. Good news is that it works for most. Cremaffin is a standard laxative and laxatives are the first line treatment for fissures. Fissures usually happen due to hard stools, they can be themselves be the cause of hard stools and get worse or fail to heal with consecutive episodes of hard stools. Laxatives work to make it soft so that fissures can heal faster. * peptic ulcer disease is when the inner lining of your stomach is damaged. One of the causes for this can be increased gastric/stomach acid secretion or prolonged exposure of the stomach lining to these acids. * prucalopride makes food from your esophagus and stomach faster which actually helps reduce acid exposure. Thus, in theory, it would have a protective effect rather than harming your stomach. However, if you are having abdominal pain, dark stools, red stools or blood in stools. Stop taking the medicine and consult your doctor. * cremaffin works by lubricating the digestive tract and adding water content to stools to make it soft. This again should not harm your stomach or old healed peptic ulcer. Cremaffin can cause anal irritation sometimes but that is rare. Both these medicines along with other strategies that your doctor must have explained to you: - use of sitz bath - good hydration - high fiber diet - ointment prescribed by your doctor to apply in the anus - some exercise can help heal your fissure faster. I hope this has been helpful and I hope you get better soon.  

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