• Instead of using toilet paper, try using baby wipes with aloe for a while (not flushing them of course). You clearly have anal fissures. Therefore, just as when our lips crack or our fingertips crack, we have to protect them and keep them soft until they heal. Keep doing the high fiber and lots of water regimen, but add topical treatments like the wipes and maybe some Aquaphore.
  • Keep a careful balance with the fiber, don't overdo or you'll be worse off. You can put lotion on your tp, or use aloe baby wipes. You might add topical creme. Go to the pharmacy and look around. Make sure cetyl alcohol (or any other alcohol) isn't very far up the ingredient list on the product you suggest. If you aren't shy, you can ask the pharmacist.
  • Not that I have to tell you this but 10 months is a long time for unhealed anal fissures. You really need to return to the doctor and tell them that you are going to need prescription help, at the very least. Something like a nitroglycerin ointment. Or the high blood pressure medications nifedipine and diltiazem. These medications relax the pressure of the internal anal sphincter and that can allow the edges of the fissure to come together and heal. Botulinum toxin (Botox) is also being used to treat chronic anal fissures. The injection of Botox temporarily paralyzes the internal anal sphincter, (I know scary thought that is!) which allows the fissure to heal. Surgery may need to be considered if medications do not stop your symptoms.
  • Most will not be able to help you with this unless in the medical field. Ask your physician if it could be due to some kind of bacterial infection though. Stick with medical experts on something this serious not online well wishers- and keep up with the fiber and water- no matter what you need that for a healthier you.

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