I suffered from truly brutal and relatively deep fissures for over a year. I'll spare you the details as you have heard them before - felt like passing glass, long time spent in the loo shaking and sweating, etc - it truly had a horrible impact on my life. I had tried all the usual remedies including Nitro cream, warm baths, diet changes, etc. The fissure might heal temporarily, but would open up if I so much as blinked the wrong way. Honestly - they were so long lived and so terribly debilitating - and I seemed unable to improve the situation, I put myself on the list for surgery (however reluctantly).
This was about 5-8 years ago, when PEG was just becoming widely available. When I first discovered it, I read as much as I could about it (it's effects, including level of dependence after long term use). Anyway - I thought I'd give it a go. I was on it for about a month when I saw my proctologist and told him about it. He asked me what it was (!), and suggested I keep him informed as to how it went.
Anyhow - I found the fissures would go away while I was on it after a week or two of use, but then return almost immediately when I went off it. So I was pretty much resigned to being on it for life - and indeed stayed on it for at least 6 - 12 months.
After 6 or more straight months, I very very slowly started weaning myself off of it. Essentially I went from the full daily dose to completely off of it over the course of about 8 - 12 months. I found if I moved too fast off it, it would re-open, but very very very slowly over time, I was healing.
Finally, after over a year of being on it and *very very* slowly going off of it, I find myself in a position where I am essentially cured. It takes a pretty serious bowl "event" to re-open it - in which case I go back on the full dose for a week or so, then wean myself off of it for the following week or so. That happens rarely now - maybe once or twice a year - most commonly when I am traveling. But I can absolutely report that I am in a position now where I am basically 100% cured. And honestly - I have to tell you - I was in such a bad state I thought I was totally beyond hope.
So - the lesson I learned was that I needed to be on this a very long time (half a year or more) to fully heal the deep fissures. And then I had to come off of it even more slowly to develop the strength and have the flexibility return so as not to create a new problem. But I am one very happy camper now - and (thank goodness) - no surgery.
I know you have heard stories like this - but I wanted to share mine in case something in it is helpful to one or more sufferers.