SSH,
I hope you are back on track for getting better! The following is just my opinion, but it helped me put my AF in perspective.
I discussed this in detail with one of my CRSs...the one that schedules atleast an hour for each appointment. He said that there are two stages of healing. The first is when the ends of the AF come together and close, and then a follow up period where the tissue "fills in" over the scar. He said once the tissue fills back in over the scar, a patient is back to normal. He's being doing these for 33 years so I definitely feel like he knows his stuff and his explanation makes sense.
But to be more specific, I think this is a better question for your CRS after examination. My CRS said that lable "acute" and "chronic" only refer to length of time with the AF, not the condition. However, I think there is a natural relationship between a chronic AF and it's condition, but not a rule. So to effectively answer that question, I think you need to know the condition of your AF.
The second thing I think is important is the pressure of your resting sphincter. If you have a naturally high resting pressure, then I think you are going to have a less then normal chance of healing it and keeping it healed. More to the point, even after healing, one may continue to have additional AFs because the high resting pressure is always present.
I think the final piece of the puzzle is thinking back to how you injuried yourself. I remember when I did it and I was passing massive and brick hard stools a few days in a row. TMI...sorry! So that leads me to think that perhaps my diet was the underlying issue and not something else. In my opinion, people who feel they just got the AF one day without a monster BM or two or some underlying inflammatory bowel condition may have gotten it from a change in resting pressure of their sphincter. If that's the case, then I feel surgery would be the solution.
For me, if I can't heal it after 8 weeks of treatment with a good diet, baths, and Nifedipine, then I'm not even going to think twice about surgery. I personally view the surgery, when done correctly by an experienced professional, as "insurance" against future AFs. I almost want to have it right now, but I feel like I border on the possibility of healing it naturally.
Good luck with your AF!

Hey Chris/Lecia,
Thanks so much for your help. Chris your explanation was really helpful & did put things in perspective. I got my fissure because I was travelling in a 3rd world country and was at a hotel (relatives wedding), eating cheap restaraunt food for a couple of days. I was eating lots of cheeses and constipating food, and what was worse is that I somehow got food poisoning, but I didn't realize it because I was taking a herbal medication that was supposed to protect the stomach from toxins. This herbal medication plugged me up soo badly that I became really really badly constipated.
I was taking the herbal medicine for probably 2-3 months on and off, and I remember one time when I was on the toilet for about 20 mins trying to go. It was an awful experience! I had NO knowledge on fissures or any bum related problems for that matter!! I just felt like going to the washroom because I hadn't had a BM in 3 or 4 days. I'm pretty sure that's how I got the fissure. Before that though, there were the odd moments when I would have pain going to the washroom, but it wasn't half as bad as now. I think I had the fissure for 2 months without even acknowledging it, and finally I went to the doctor when it became too painful.
My CRS told me he doesn't think my fissure is chronic, but I think it is. I know I've had it now for at LEAST 6 months. I have some hope for healing it naturally because when I was steady on my Miralax and prune juice, the pain and bleeding stopped completely (for a whole month). I wasn't even taking sitz baths much at this point and wasn't drinking my whole 2L's of water. I re-tore my fissure though because I cut down on the Miralax.
Well! Hopefully this will heal and wont come back. I've made so many changes in my diet that I really hope I wont have to deal with all of this one day. I want to be able to travel again, without having to think constantly of the bathroom, of my bum, of what food I'm eating, etc. But I don't know if that day will ever come -- Hopefully! Thanks for your help all.
xo

For me, if I can't heal it after 8 weeks of treatment with a good diet, baths, and Nifedipine, then I'm not even going to think twice about surgery. I personally view the surgery, when done correctly by an experienced professional, as "insurance" against future AFs. I almost want to have it right now, but I feel like I border on the possibility of healing it naturally.
The surgery gave me my life back, pure and simple!