I had a chronic anal fissure that did not heal whatsoever for 11 months. During this time, I went to the proctologist (aka colorectal surgeon), and he prescribed me Nifedipine that didn't heal anything (I used it consistently for 3-4 months).
Next step was going to be botox injections and then LIS (surgery) [read more about that here]. I didn't want either of those. It would make sense that a colorectal surgeon would recommend these things as they are primarily surgeons. My goal was to both heal and avoid invasive treatments, so I tried all kinds of things and read A LOT of research.
(Go to scholar.google.com to give your own research a go).
I finally healed! This is what ultimately led me to healing:
Chair cushion at work in my office chair allows for less pressure on the anus when you sit. It's actually very comfortable. You can find it here: https://amzn.to/48UJKHi
Note: I couldn't use it in the car, as cold temperatures caused the seat to harden. But once it warms, it returns to its squishy normal state.
Bathroom Habits
Remember those silly unicorn pooping ads about the Squatty Potty? Well, turns out they were on to something. Elevating your knees with a Squatty Potty aids in relaxing the anal muscles, making it easier to pass stool. I find that a 7" height works well.
Before every bowel movement, I use a gloved hand and vitamin E Vaseline to lubricate the anus. Vitamin E is a known skin healing aid. Dermatologists often credit Vaseline for helping heal wounds (search "Vaseline Wound Healing" on tiktok where many dermatologists make their suggestions).
After every bowel movement, I hop in the shower. I use this shower head which is long enough to reach to the floor of the shower (70 inch hose). Squat over the water spray and gently spread the butt cheeks. Gets me cleaner than any toilet paper or bidet ever could.
While in the shower, I use coconut oil which is generally thought of as safe for skin. I use this in combination with the ProctyClean.
Here is the ProctyClean link: https://www.proctyclean.net/en
Once I started using the shower and ProctyClean method (while squatted in the shower and using the shower head above), the pain from the fissure improved significantly (prior to using it, I was in pain every single day). Turns out, feces in an open wound hurts a lot.
While ProctyClean improved my situation significantly, I wasn't fully healed until I started using this vitamin E ointment which is also not sold in the U.S.
Filme Oilo is an Italian-made ointment specifically designed for healing the genital anal region and can also be used on hemorrhoids. I first learned about the vitamin E ointment from a research study on chronic anal fissures that took place in Spain. After some hunting, I discovered that the vitamin e ointment (aka tocopherol acetate ointment) was specifically Filme Oilo.
I apply it with a q tip inside the anus where the fissure is. (Note: Vitamin E Vaseline can help with lubrication if needed in this step). I apply Filme Oilo after every shower with a q tip while squatting over a hand mirror. Then I get dressed and go about my day. I know for a fact that I most likely have the cleanest and most cared for anus on the block!
Even now that I'm healed I know I can retear more easily than if I never had a fissure at all, so I am very careful and continue the exact same protocol every day.
Note: You must not do the same things that led to the fissure in the first place. Often times this is diet. Constipation is often a leading cause of anal fissures. Article about eating healthy to prevent constipation coming soon!
Good luck with your healing journeys.
One and a half years later from the initial fissure, I can say that I am healed.
I pray that you will experience the same.
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