Some of you know that I have been suffering with multiple deep fissures for more than a year now and have already been to several top-rated surgeons who all agree that surgery isn't a good option for me because of other health problems and my medical history. So, my only choice has been to learn how to live with fissures. I thought I would just share the things I am doing to manage this new life in the most comfortable way possible. Though none of this has cured my problem (yet), it all does make life more live-able with fissures. I pass it on for whatever use it might be to anyone else.
1. Soft stools that are thin and easy to pass. For everyone, achieving this requires a lot of experimenting. For me, it means one Colace (100 mg), 1 tsp. of Miralax and 1 tablespoon of acacia (100% soluble fiber) per day. I drastically reduced the amount of fiber in my diet because all that fiber I was eating was just making stools too big and stretching and re-tearing me even deeper every time I would go to the restroom. When I do eat fiber I focus on soluble fiber and limit insoluble fiber. Because of severe digestive dysfunction, I live with frequent bouts of diarrhea daily, but do use the stool softener to make sure the first trip to the restroom in the morning isn't too traumatic.
2. Posture when going to the bathroom. I sit on the toilet with my feet raised and I lean forward, which helps relax the pelvic floor. A full squat doesn't work well for me as it puts too much pressure on the anal area. I have learned how to use my abdominal muscles and breathing to reduce the pressure on my anal canal during a BM and I never strain.
3. I apply a glob of Vaseline before every BM to ease passage of stool. After a BM I clean throughly with moistened toilet paper with plain water (never wipe, only blot). I follow this by cleansing with Aubrey Organics aloe vera, which is very liquidy. I follow that by using a gloved finger to clean internally with Sweet Blessed Bee Magic healing cream. I find that making sure everything is very very clean goes a long way to preventing irritation later. Then I apply Mayinglong Musk Hemorrhoids Ointment, which has a very cooling and soothing effect.
4. Sometimes I still use nifedipine topically, but not as often as I used to as it causes side effects.
5. Anal dilators and muscle massage. I use dilators at home to gently stretch and relax the muscle. This is based both on email discussions with people who have had success with healing longstanding fissures gradually dilating at home as well as the advice of my most recent CRS.
6. Deep abdominal breathing, stress reduction, and pelvic floor stretches. I do some of the stretches in Amy Stein's book every day and practice deep abdominal breathing at multiple points throughout the day, focusing on relaxing any tension in the anal area. I also sketch, paint, and write poetry to manage stress. Here is the link to Amy's book.
http://www.amazon.com/Heal-Pelvic-Pain-Strengthening-Incontinence/dp/0071546561/ref=sr_1_1?ie=UTF8&qid=1353869049&sr=8-1&keywords=amy+stein7. 
7. Supplements and Diet. I take magnesium for its muscle relaxing properties, a probiotic for my digestive system, vitamin C and zinc for wound healing, and make sure I get plenty of mixed carotenes in my diet also for wound healing. I try to avoid sugar. I avoid spicy foods and limit acidic foods to prevent more inflammation. I also avoid onions and garlic for the same reason (and onions and garlic also don't agree with my stomach anyway). I avoid popcorn and other sharp foods as well as gluten and dairy. My diet is very strict and very limited and I never cheat. This is not just because of the fissures, but also because of coexisting digestive problems.
So, that's about it for now. I've tried dozens and dozens of topical creams and ointments and oils, etc. The products and tips I listed above are just the ones that help me. Everyone is different, and there are any number of different things to try out just to see what works. 
I wish for relief and healing for everyone.

Thank you so much for posting this Jr2. I really do.feel for you, but I am glad you have found a good variety of things that work for you.

OMB x

Jr2, what kind of pain are you having?

Thanks! I really like these kinds of posts. They've helped me put together a routine that works for me.

JHH,
I have different kinds of pain. 
1. The pain of the fissures themselves, which feels the way a cut feels. Stinging, sharp, throbbing, burning, etc. Also, just a generally really irritated, raw feeling all the time.
2. The sphincter spasm pain, which makes the pain above much worse. In the beginning I wasn't recognizing it as spasm pain because I was thinking muscle spasm like the way a muscle spasm in the back or neck feels. For me, it is a tightness, and can often feel like I'm sitting on a golf ball, which tells me it is likely not only involving the internal anal sphincter but also other muscles, possibly the levator ani and other pelvic floor muscles. I already know I have pelvic floor muscle problems from so many years of abdominal and pelvic pain, as well as from several  surgeries involving the abdomen and pelvis.
3. Nerve pain. I already suffer from chronic nerve pain in the pelvic area from previous surgeries so I'm familiar with what that feels like and I'm convinced that having had these fissures so long has now set off nerve pain, which is burning and shooting, like lightning, that is different feeling than the pain of the actual skin burning, stinging from the fissures themselves.
4. On rare occasions I will get a spontaneous attack of proctalgia fugax, which is just a fancy name for a sudden, very sudden, very severe spasm of the rectum/anus that feels like I'm being ripped open on the inside. The episode itself doesn't last that long, but it does cause soreness for about a week afterward.

Yikes...
Do you feel the dilaters, and massage is helping you?

Very, very much so. It takes a lot of patience, time and perseverance, so it isn't for everyone, but both massage and dilating are essentials for me. Those few of us who have tried dilators and really stuck with the practice over the long term have found it to be helpful enough to keep doing it. That's kind of how I judge the things I try. If it's something I continue to reach for in the fissure tool kit, it must be doing something useful for me.

jr2 you are truly an expert of fissures and I admire you for living with this pain and discomfort.
Fissures are not an easy condition to live with.

jr2-
you said you use Mayinglong Musk Hemorrhoids Ointment.
i read that it shrinks skin tissue for hemeroids.isnt that bad for fissures?

delasama
not necessarily. This medication is actually also indicated for healing of anal fissures. Mostly, there is a lot of crossover between treatment of hemorrhoids and fissures. People think they want reduced blood flow when treating hemorrhoids, but actually, you want better blood flow for both hemorrhoids and fissures. This medication was recommended by a Physician of Chinese medicine. In shrinking and removing tissue as the fissure heals you are promoting fresh skin that has a chance to heal more cleanly. It also has antibacterial properties to keep the wound clean. Honestly, it, combined with the Sweet Blessed Bee Magic, have been the best topicals I've ever used (along with the nifedipine). Everyone is different, of course, but I've literally tried about a hundred different things.