i don't know about the wipes - i would use something that doesn't have witch hazel. maybe an aloe medicated baby wipe. better yet, shower or take a hot bath after BM to clean the area and promote circulation.
i've used neosporin on the anus off and on to promote healing. since i'm not healed i can't say if it works or not, but it's comforting to think i'm doing something to help. and it feels kind of soothing down there for burning, stinging.
i have always been able to see my fissure. i use a hand mirror and kind of gently open the area and i can see the tail end of the fissure. it was much more visible a year ago, but i can still see a little crack-like opening. definitely don't fiddle with it too much. it doesn't help to see it, if you can feel it it's there.

If 2 stool softeners a day aren't working consistently you may try taking more. I've heard of people taking 2 per meal.
also, be sure to cut anytihng that might be remotely constipating out of your diet for a little while.
For fiber, I like glucomannan, which is a japanese yam fiber. It hold more water and is less scratchy than many other fibers.

BG ! Where do you by glucomannan? Is it also powder or is in pill form? Sounds nice and I am kind of getting tiered of Metamucil although it works great for me as long as it is in powder form. Pills do not work - it is so funny, you can actually see in the parts of the poop where they "popped" open , ha ha , like normal poop than 2 inch "fluff" , than normal poop - I was lucky that my "normal" poop is never hard - for somebody else that would be disaster : (..
Juney, did you ever asked them to do "advanced anal flap fissure repair". They use your skin and graft it over the fissure - it is done 1 in 100 procedures. It is more expensive and requires hospital stay, I think that is why they use it rarely. I don't really know much more about that procedure, but maybe you can do some on line research.

You can find the glucomannan at a drug store. It's part of the digestive advantage chronic constipation pills, which contain glucomannan and a probiotic. Or you can find it at a health food store. There are several brands that just sell plain ole glucomannan tablets. I take them with meals to prevent the weird inconsistent poos--I had those too, excpet the metamucil turned hard in my gut so it was normal poo, super duper big and hard poo, normal poo. I quit that the next day.

fiss - i did ask about the advancement flap thing and my dr pretty much dismissed it, saying he never does that. i can't remember his exact reasoning, but i didn't ask again after that

my dr dismissed it too, but it does seem like such a good idea...I'll se what my new guy says on the 23rd.

BG : ), thanks for the info !!! I was laughing so much when you described opposite spectrum of what fiber pills can do, isn't it fascinating how everybody has different digestive system ??? Like we are all fro different planets or something !!! ; )))
Juney : ) - My opinion is that he never does it because he does not know how to do it. Also, since it is expensive, insurance would not maybe cover it if does not "make a case" and he might not want to go through the hassle. I think that one person on this board had that procedure - one of the oldest post under "surgery" topic. I found extra info on Mayo clinic website (about 1 in 100, for example). That procedure also probably requires more expertise, so I am sure not all CRSs know how to do it. I also once read that it is more often done for women who got f. after delivery. AND I AM SURE THAT WOULD BE DONE FOR ANY VIP !!!
So, I think it is worthwhile exploring ! Just couple days ago I found the article about complete reconstruction of vagina and colon after some poor women had whole thing falling apart during extremely difficult delivery. After surgery there were NO further problems and tha whole "apparatus" was working perfectly. And
we have to beg for primitive LIS or skin tag removal - GEEEEEEZZZ !!!!!!! And they still mess up even there ????????

I know, Fiss!! I think these medical decisions about what "appropriate" treatements are must be made by non-sufferers, who just assume that most people will heal on ther own or with minor help. It certainly is less expensive that way and time does heal a lot of wounds. But if our healthcare system were truly patient-centered, I think these ideas would be broached more seriously. Wouldn't it be nice to just have to heal a line of stitches rather than a gaping wound???? I know that primary skin closure w/ stitches takes place in 24-48 hours. Not eating for that period of time, esp if sedated and on IV seems like small potatoes...

yah my surgeon was just a general surgeon so he was probably only familiar with LIS. he said the CRS usually only sees people with anal problems worse than fissures (as if this is a simple problem?!) so after my 2nd surgery he finally admitted he had no more ideas and sent me to the CRS. All she could suggest was botox, not a 3rd surgery at this point. I feel like they've tried their best to help me, but only with what's worked for others in the past. It's definitely not an experience that's tailored to each specific patient. If i see that CRS again i'll ask about other options.
at this point, i can handle things with the MOM and i'm not in pain everyday so I would hesitate to go in for another surgery. if i ever get up the nerve, i'll try skipping the MOM for a few nights and try it on diet alone. if my butt can't handle a normal poo i'll definitely make an appt! and this time i'll look around outside of Kaiser.

From my experience at Kaiser, I'd say DEFINITELY shop around. I had to demand to see the two Kaiser CRS's in my area, and by my area I mean within 50 miles. Neither of them struck me as very competent, though one was MUCH nicer than the other. My general surgeon at Kaiser was arrogent yet incapable of dealing with my fissure. Everytime I'd go in, he'd say I had an acute fissure and come back in 4-6 weeks--that is until the abscess I TOLD him was there exploded. And my GI diagnosed me with a possible Crohn's and then forgot about it--I don't believe I have it since I don't have any symptoms except for this fissure and the diagnosis was unclear, but not following up with an appt or treatment seems boardering on negligence to me.