I finally got a diagnosis and I was so nervous that it would be a really bad fissure since it was long term but he said it didn't seem to bad. I just keep aggravating it and reopening it because I'd get constipated again. He said to just keep doing what I'm doing with the water and fiber and miralax when needed, and if it doesn't get better we'd try diltiazem
I feel a lot more pace now because I don't have hemorrhoids, just a sentinel pile ...but it doesn't hurt me and my body seems to be doing is job in healing me.. provided I do my job and drink metamucil!