Brief Answer:
Do not worry, anal fissure most oftenly heals well..

Detailed Answer:
Hello, XXXXXXX
I am really sorry to hear this but do not worry..
I thank you for posting your query here..
Welcome to HCM..

I am Dr Manjunath..
I read your question completely and have understood it well enough..

Please note the following few facts XXXXXXX .

1. Anal fissure is a really disturbing problem, and most of the times it will heal well provided we give time and necessary help for it to heal..

2. Need few other details
Does it pain even now?
Because, sigmoidoscopy that you mentioned in history should not be done in a case of fissure.

3. 41 years is not that bad for you to suffer from fissure.
Because I understand if it was old patient, for them to avoid constipation would be a tough job.
But for you, it should not be a problem.

4. Basically you have to avoid constipation. That is most important for healing of a fissure.
This is achieved by
A. Drinking lot of water
B. Eating Fibre rich food, vegetables and fruits.
C. Avoid or reduce non veg if consuming.
D. And use stool softeners that you are already using.
I am sure you would have followed all these..

5. We see a lot of such cases where fissure won't heal with all these conservative methods.
One year is a long time.
I agree with you that, generally fissures should heal in 3 to maximum 6 months of time.

6. In such cases, we go for surgical procedures.
It's called lateral internal sphinterotomy.
This effectively heals the fissure..

7. And I suggest you to stop, cremaffin. One year Is a long time.
But you can continue using local applications for pain as prescribed by your doctor.

Hope I've answered all your points..
In case you need further assistance, please let me know..
Take care, happy recovery..

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Brief Answer:
You can wait for surgery

Detailed Answer:
Hello XXXXXXX I thank you for getting back with your doubts..

Please note these following things..

1. If pain is minimal, then no need for surgery.
See, decision for surgical intervention is based on patient's response rather than the disease most of the times.

2. Yes, I suggest you to wait and see how you improve..

3. I suggest you to stop lactifibre too if you are using for more than a year.
Please use natural methods of avoiding constipation.
As I've already described.

4. Local application also, please use only if you have severe pain.
You can use that same or go for SMUTH gel. Anything will do..

Hope I've cleared all your doubts..
In case you are satisfied with the answer, kindly close and rate or you can ask any other doubts.
Take care..

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