I made an appointment with a naturopath/natural healer, very well regarded, here is her take on anal fissure:
1) surgery is highly unlikely to resolve the issue long term
2) diet is only 50% of the issue
3) thoughts are the source of the issue, negative thoughts, depression, FEAR is the key, those who live in fear of life and challenges suffer from a colon that tenses up, the colon and mind are intimately connected
4) eat foods that promote body alkalinity, acidic body is a diseased body
5) squat when pooping, breathe, relax, do not anticipate pain
6) do light yoga, meditate on relaxation, remove all negativity in life, including partners that stress you
7) avoid meat, dairy, gluten

That's about it. All I can say is that she was the healthiest person I have ever seen, vibrant with glowing skin and positive energy, hard to explain yet clearly evident.
I expected her to try to sell me a bunch of herbs and potions, she did none of that, just a talk, her expressing her opinion on the matter. She took my bp, told me I had stress from work, I am in fight or flight mode, hmmmm, I think......she's right.
I want all of us to heal. This post is purely her take on the issue. Hoping for healing for all of us suffering.