My brother has been diagnosed with an anal fissure , has had constipation and pain with bowel movements for about 3 months, He has seen a physician and has been given a nitroglycerin compound cream. Which he has been using for about 3 weeks. He has been instructed to use warm bathing or warm moist heat to the area 3 x daily. If this does not help the Dr. said that he could have surgery done for the fissure and hemrhoids. My question is this, My brother smokes about a pack of cigarettes a day, Would you be able to tell me how this effects his healing in terms that I can explain to him as he is having a difficult time quitting? Also from what I understand the fissure isnt actually repaired with the surgery, it involves the sphincter area is this correct? Thank you.