Hello SSK,
First off I wish you a speedy recovery.
Regarding your job - that is something you have to deal with.
Regarding your fissure - I can suggest a lot of things. You telling that you are Indian helps even more in providing the suggestions.
Fissures are about managing a soft-stool and promoting blood circulation. Fissure site does not recover due to anal pressure, spasms and lack of proper blood circulation. Slow walking promotes blood circulation but with a recent tear one should not walk or climb stairs or lift weights as it can cause chaffing, strain and re-tear further.
A softer stool can be managed through a combination of drinking lot of water, eat non-soluble fiber and soluble fiber.
Non-soluble fiber is not digested by the body and it holds the stool mass together and the body moves such a stool faster through the intestine.
A key function of the intestine is to absorb water from the stool material and make it hard...So you have to eat smartly so that your stool will hold on to the water. This is done by eating soluble fiber. Soluble fiber content will hold on to water and resist giving up water. So such a stool will retain water till it reaches exit point of the body. So you have two things working for you - soluble fiber holds on to the water and body moves non-soluble fiber out because body cannot digest it. So your stool is moving faster and remaining softer.. Once you understand how the body works, it's all about taking advantage of this and planning a diet around it. This is very very simple to manage.
REMOVE following things from your diet -
-chicken, mutton, fish, shrimp, cartilage, any other meat.
- alcohol
- fried stuff like pakoras, dahi wads, fries..
- cheese, milk, chips, nuts, crackers, biscuits, cookies, white-bread, tamarind, egg-plant(brinjal), tamarind, red-chilli, green-chilli, black pepper, spices, rice, Naan..
Now you will ask me what should you eat then? Good question.. So you can eat the following things
- Roti with ghee
- Lentils (plain daal)
- Green vegetables ( cabbage, cauliflower, okra, green beans)
- Beans in limited quantity ( rajma, chole)
- Drink prune juice three times a day
- Dinner take only fruits - papaya, water melon, pine-apple, oranges.
- Two spoons olive oil at lunch and dinner.
- Drink 2 to 3 litres of water daily.
- One spoon of benefiber in water three times a day. If you get too much gas then cut down to twice a day.
In addition you can try a stool softener such as colace (50mg) twice a day to keep soft stool.
What you eat is what comes out. Fissures can be managed by a healthy diet. Once you get a fissure is when you realize the importance of health diet. I am telling you from experience. I did have my LIS surgery and ever since then I am on a strict diet because I do not want the problem to come back. I am ready to live a regimented life. It is pain free and nice.
Never push during a BM. Also you can take a fleet-enema on the days you don't get the urge at all worst case scenario.. Try to drink a glass of luke-warm water as soon as you wake up.
Also whenever you have a meal make sure you eat so you are full..Dont keep a empty stomach or eat a half meal. When the body has a full meal, the stomach sends a signal to digestive system.
You should use soft baby wipes(non scented) for cleaning after BM. Do not move the wipe in a wipe motion. But use it to gently DAB ( imagine you are cleaning oil spilled on floor - you would dab with a cloth not try to spread oil).
After every BM, sit a tub full of warm water for 20 minutes. This is called Sitz bath. Take 3 to 4 stiz bath daiy. Sitz bath promotes better blood circulation, relaxes the tissue and nerve bundle and can promote healing of the fissure.
Once again I am not a doctor. I am just a patient who suffered through AF for 8 long years before having LIS surgery. I did a lot of research, saw videos of the LIS surgery and getting surgery done was the best thing. There is no need to be scared.
If you go to India you can get LIS surgery done and they will admit you in the hospital for 3 days - so hospital staff will take complete care of you. Also in India they give antibiotics for faster healing of surgery site.
I had my LIS in the US here and I stayed home for a month after surgery and family took care of me here.. Also in US the doctor did not give antibiotics for surgery site.
It is upto you how you want to handle your fissure... Try all medicines first - nifedipine, good diet....If you still don't heal then go for LIS. So in your mind you know you have tried everything before surrendering to the knife.. After you have the surgery you will feel it is the best :)
Wish you a happy road to recovery and a good life.