I thought I would share what's worked for me in case it might help someone else who's struggling. I don't consider myself totally out of the woods yet, as I've only been pain-free for about a month and still get a slight pinch during BM sometimes but haven't in several days. I don't know if I've healed because of what I've done or because my case just wasn't that severe, but here goes. First a quick recap: I developed a fissure shortly after the birth of my little girl seven months ago. For several weeks I suffered horribly as I was misdiagnosed over and over (everyone said hemorrhoids) but after way too many days of shaking and crying in bed for hours following each BM, literally screaming with pain every time I had to sit up to nurse my daughter, and being completely unable to walk (my husband had to help me get to the bathroom) I hounded the doctors until they finally got me in to see a specialist who quickly diagnosed a fissure. He prescribed Diltiazem and that helped a lot, but the next several months were full of relapses as I struggled to find a diet and routine that worked. I also have a little girl who just turned 3, so this has been traumatic for her too, seeing her mother is so much pain. I had to call my husband and work, crying, telling him I couldn't handle the kids the way I was.
Here's what has worked for me. I ate pretty much exactly the same thing every day for months when I figured out what seemed to help. Breakfast: Oatmeal. 1/4 (dry) with a touch of honey and almond milk to cool it. I never gave up my one 8 oz morning coffee, but I cut out all dairy so no cream. Snacks: Bowl of Multi Grain Cheerios with almond milk. I never measured, just ate as much as I wanted. Lunch: Egg sandwich w/ two eggs, two slices of whole wheat bread, mayo, mustard and a tiny bit of ketchup. Snacks: Usually mini cucumbers dunked in hummus. Dinner: A big sweet potato cut up into fries and cooked in my Actifry with olive oil or coconut oil, peel included. Plus a filet of salmon. Later I would usually eat a mango or nectarine for a snack, and more mini-cucumbers. I snacked on prunes throughout the day, but honestly lI didn't notice a difference when I didn't eat them. I ate tons and tons of blueberries when they were in season. Every evening I still drink one dose of Restoralax (Miralax.)
I had to give up Diltiazem after several weeks because I developed a rash from it. Every time I would relapse I would try it again for a few weeks until the rash returned, then I would just apply a bit of coconut oil. I found that after BM, cleansing with damp paper towel or fragrance-free, flushable wipes worked best ( I used Babyganics brand), and twisting the end and cleansing inside slightly to get any missed residue off helped a lot (I noticed my healing sped up after I started that).
THIS HAS BEEN THE MOST CRUCIAL PART OF MY RECOVERY: I noticed any time I had even slightly firm BM's and had to strain or push even the tiniest bit, I would relapse. So I bought glycerin suppositories, and any time I sat down and felt like I would have to push, I stopped everything, inserted a glycerin suppository and waited at least 30 minutes. This lubricated everything and softened it. Once I started doing that I stopped having those relapses and I was able to heal fully (I hope). I got constipated once and was so afraid of what was going to happen that I inserted a suppository right before bed, kept it in all night and I really believe that saved me from a horrible relapse.
This whole thing has been very life-altering and I've really had to be strict with myself and stick to this plan. I gave up junk food and processed foods 100%. Several times I've decided to try naughty foods after feeling better for a few days but I would relapse. Now that I've felt better for a while I've been introducing different foods but very slowly and I'm still on my 'fissure-friendly diet' for the most part. I've had a bit of sushi, a bit of cake, even steak, but I'm keeping portions small.
Things that set me back: Tomatoes, though I've started eating them again just a little bit with no aggravation so far, but while I was healing I couldnt' eat them without a setback. Crackers: I usually eat brown rice crackers with hummus but started noticing I would get bunged up when I ate them. I might have just eaten way too many of them. Also, if I forgot to eat enough fruit and veg every day I would get bunged up. Mini cucumbers have been great for me. I also tried dairy several times because I love it so much, but always suffered a setback because of it. Prune juice made things too soft for me, as did magnesium. I found once I was mostly pain-free, the healing sped up when BM's were soft but formed, not liquid.
There, that's all I can think of. My main advice would be to dedicate a chunk of your life to nothing but getting better. If you have to, be anti-social, don't drink, don't eat out, do everything you can to fight this thing so you can get your life back. Of course, people have to work and whatnot, or chase kids around like me, but just really concentrate on getting better to try and prevent years of suffering.
That's all I've got. Hopefully someone finds a glimmer of something in my rambling that works for them. Hopefully this isn't premature and I'll update if I have any more relapses and explain what I think did it. Good luck!