I've been suffering with anal fissure, very severe chronic one. I was able to heal twice but it came up ..
I'm very disciplined ..but last time fissure came back with revenge.
I'm eating only fruits and veggies from blender... and managed to decrease my pain significantly .. but I have a big problem pooping.
My stool is near perfect ice cream.. but still it has to squeeze through. It is that tight that it is impossible to push finger through.
Diltaezem cream might relax anus spasm.. but when I try to insert the finger it seems super bulky there, plus fissure is at 3pm(or 9pm)
.. the bulkiness does not go away .. last 40 days.. Worries me it's something else..
I can insert care fully very small injection with tons of lubrication with coconut oil, but finger .. it's impossible.
I went to colon surgeon and he says the fissure does not look bad and because of stiffness he says he'll try in 4 weeks.
I have another surgeon to take a look next week.
Really worries me ..

I can function .. after stool.. ibuprofen and the pain is manageable.. but I"m afraid that as the time goes the stenosis is worse or maybe tumour.. cancer ...
7 months ago when I had my first hell with anal fissure I did colonoscopy

.. and it came up clean with minor internal hemorrhoids... but that was 7 months ago.

I was so focused on fissure and management of extreme, long term pain... but now I'm not sure that is the only problem.
Thoughts?

I'll update your after next surgeon appointment

You are NOT helping yourself by having your stool "perfect ice cream." You are supposed to have big, bulky stools. Not dry and hard and not soft and creamy. What you are now experiencing is the tightening of your sphincter so bad that you will have to strain with every BM for the rest of your life. How do I know? Because my rectum got tighter too and I had to strain for every BM. That was it - I got the LIS as soon as I could. If you are that tight you have nothing to fear from an LIS - your sphincter could crack a walnut like mine.

Over analysis leads to paralysis.

Your fear of surgery is holding you back from this nightmare coming to an end. Get the LIS and get on with living a normal pain-free BM life! The doctors have to know this by now. Either they are taking your easy money by "treating" you and stalling the inevitable or for some reason they think they can reverse this. If you have a lot of stress in your life (love life, job, money, economy, politics, etc) you are not likely to be able to get past this as stress helps contribute to the tension down there and tension is the enemy of blood flow which leads to healing.