Anyone had any success getting Proctitis/fissure combo under control?

So this last year after switching to a new GI, I managed to get my left-sided Ulcerative Colitis FINALLY under control for the first time with the addition of Mesalamine enemas and suppositories to the oral Mesalamine I've always been taking, but I still have an issue with Proctitis which is still tormenting me to no end. I also have a fissure I've had on and off for years that for the last year I've not been able to heal for more than a few weeks at a time because my Proctitis has never really gotten under control (even less so in the last year).

I've been applying Nitroglycerin to my rectum and Calmoseptine externally twice a day, which occasionally appears to relieve my symptoms somewhat, only for them to come roaring back with no apparent rhyme or reason. And I can never quite tell what's acting up, the fissure or the Proctitis. I haven't had a BM without SOME kind of pain in over a year. Sometimes I just feel irritation, throbbing and a burning sensation and other times its like I'm literally crapting glass. Overall the pain varies from feeling extreme burning, irritation and swelling of my anus, to only feeling a burning sensation mostly inside when I'm applying the nitroglycerin to my rectum.

Luckily taking a stool softener every morning keeps my stools loose enough to be able to pass them without putting too much strain on my anus. I'm one of the UC'ers who gets constipation instead of diarrhea (hence how the fissure originally occurred back around when I was originally diagnosed 4 years ago). If I were passing solid stools I would be in a LOT more pain.

I just can't make heads or tails of what exactly is happening down there and why nothing I've done to treat my Colitis is helping at all with my Proctitis.

Has anyone had any luck treating Proctitis as its own issue after getting their Colitis under control? Does diet affect Proctitis similar to the way it affects Colitis? I avoid some of the normal things, like wheat, dairy, soy, corn, most sugar, which seems to help with the Colitis (and I take a bevy of supplements), but could there be something I haven't cut out (like rice) that could be aggravating my Proctitis separate from what would affect my Colitis? Does it even work that way?

Just a little at the end of my rope and would be grateful to hear about anyone's experience with this particular scenario. Much obliged!

I have dealt with an anal fissure in the past.
After almost two years of using Diltiazem on and off with very very little results I was given a gel containing these (I am not writing the product name as I am not sure this is allowed):
GLYCERIN, PRUNUS AMYGDALUS DULCIS OIL,PHENYL TRIMETHICONE, BORAGO OFFICINALIS SEED OIL, MALVA SYLVESTRIS EXTRACT, PANTHENOL, DEXTRIN, HYDROLYZED HIBISCUS ESCULENTUS EXTRACT etc...

This gel helped a lot more and got me rid of the fissure.

iPoop, thank you, that was helpful clarification. So, ok, yes, I have Distal UC. And for whatever reason my treatment appears to be able to suppress symptoms everywhere but my rectum. Is that a thing that can happen or would it be more likely that I'm misreading fissure symptoms? These are all questions I'm asking my GI in a few weeks, but was just curious what the community might have to say.

paduk, Thank you, yes would love to know what the gel is! I was also on Diltiazem for a bit before being switched to the Nitroglycerin. I'm worried my GI's next suggestion is going to be surgery, so would love to be able make mention of the option if my GI doesn't.

I have many of the same issues and also have disease that presents with constipation. There’s an amazing product called Fissure Control Oil that I discovered about a year ago - between that and adding a bidet toilet seat, my chronic fissures are finally under control. Unfortunately I’m flaring on Entyvio, so not sure what’s next for treating my UC, but applying that topically, morning and night, really helps!