Hi there, I see a lot of patients in my clinic for anal fissures, hemorrhoid and other rectal and anal disorders. The number one, two and three treatment is soft stools! The combination of straining and hard stools is what caused and is making your problem linger. Your stools need to be toothpaste soft- so whatever you need to do to accomplish that - water, fiber, miralax or probably some combination of these. No straining, no increased time on the toilet, and no hard stools. I would continue with sitz baths after each bowel movement. It will take time to heal this and there isn t really any good surgical solution. You can ask your doctor for lidocaine cream which may help some of the pain, but again this is just a band aid and won t help healing. I hope I ve answered your question. Feel free to contact me if you have any further questions.