Hi....I guess I'm in a similar situation as most of you in terms of fissures. I've had them off and on for the past 30 years (I'm not quite 62 now) and they always resolved on their own after a few days. However, it's a new chapter now. This started about a year ago when I was diagnosed with stage 3 prostate cancer. I had robotic radical prostatectamy in mid-June of 2016. One of the pre-surgery test procedures was a trans-rectal MRI that uses a coil inserted into the rectum. I didn't notice that any tearing had happened at the time. Took about 6 days after surgery for my bowels to restart, and needless to say, that was a painful process. Still didn't notice any fissure problems then. The fissure problems started about 6 to 8 weeks after surgery, when it was determined that I was going to need androgen-deprivation therapy (ADT - Lupron) and radiation (IMRT) to finish off the cancer that had escaped the prostate capsule. ADT started in mid August 2016, and about two weeks after the first Lupron injection is when I started having fissure and/or hemorrhoid problems. I had a pelvic cavity infection at the beginning of September 2016 and spent 4 days in hospital, and surprisingly the fissures cleared up. My pre-simulation for the IMRT was mid-September 2016. The pre-simulation included another trans-rectal MRI, and this time it was extremely painful and it felt like there was a tear. The fissures started again and persisted through the first two weeks of IMRT, which began end-September 2016. The IMRT treatments included endo-rectal balloons with each daily treatment. I started doing daily sitz baths, laxatives (dulcolax), stool softener (peri-colace) and fiber (psylium husk), and managed to get the fissures under control for the remaining 6 weeks of daily IMRT. Some time after the end of IMRT, end-November 2016, the fissures came back, even though I was continuing my regimen of sitz, laxatives, softener and fiber. I saw a colo-rectal surgeon in January this year, and was advised to change to Miralax and Citrucel. I'm also taking 3 TBSP/day of flaxseed meal, for it's cancer fighting qualities. In January I started on Diltiazem 2% ointment, and initially that helped, but the fissures came back in a few weeks. About 3 weeks ago, I started on Rective 0.4% (nitroglycerine) That has helped and it seems that the fissures have healed and maybe they will stay healed. However, I still have chronic burning pain in my anal region, and it often itches severely, especially after the Rective applications. So I guess now I'm looking for that magic bullet that will help keep my sphincter(s) relaxed....
I should add that chronic constipation is something I've had since my teens.