Brief Answer: Diet modification and local therapy will help Detailed Answer: Namaste Welcome to Healthcare-Magic Greetings of the day I will first try to answer all your questions first and explain you at end of it. 1. Yes it's possible for chronic fissure in ano to heal with non surgical management 2. Psychological symptoms are.due to chronic pain and discomfort associated with it 3. Best way to avoid stiffness in morning is by avoiding constipation and local application of smooth muscle relaxant like Nifedepine or Nitroglycerin 15 to 20 prior to resting to restroom. I would like to impress a very important thing which I tell all my patients, treatment of chronic fissure in ano requires lot of patients and perseverance on the part of patient and religiously sticking to treatment and lifestyle modifications like diet change. It's worth the attempt you will be putting. Aim of treatment is 1. Prevent Constipation- it's very important to that as any constipation will promote further tear and will lead to recur.It's one of the very important modality of treatment 2. Relaxing the Internal sphincter and relieving local pain - it's very important to do this as it will help prevent stress on ulcer and help in healing. I would suggest you the following which will go a long way in curing your, it will definitely help in your case as it's helped many of my patients 1. Drinking sufficient water - consume atleast 2 to 3 liter of water everyday. It will prevent constipation and will help the fiber in diet to absorb water and form formed smooth stools. 2. Intake of high fiber diet - consumption of natural foods containing high fiber is advisable especially cucumber, beetroot, citrus fruits and other fruits. ( eat whole fruits instead of fruit juices, fruits contain pectin which is good natural fiber-they get filtered out in juices) 3. Avoid constipating diet 4. Supplements of fiber like cellulose may help. 5.. local application of mixture of local anaesthetic like Xylocaine and smooth muscle relaxant like Nifedepine applied 15 to 20 minutes before resting to restroom room will relax the spasm and prevent pain of defecation. Hot Seitz bath after defecation and 're application of mixture will be.helpful. I suggest you to make all this a regular habit and sure you will be relieved of your symptoms. Wishing you healthy and happy life If you need any further assistance will be glad to assist you Take care Best Regards Dr Deepak Kishore MBBS,MS,MCh Consultant Surgeon

---

Brief Answer: no reason for concern or being stressed Detailed Answer: Greetings Smoking definitely hampers fissure healing and may even provoke spasm. Smell is common after passing feces or flatus and is not cause of concern. Fistula is abnormal opening near the anal opening and is usually associated with discharge from it. It can be excluded by examination from surgeon. From the description given by you i see no reason for concern. Take care Best regards Dr Deepak

---

Brief Answer: Wishing you healthy life Detailed Answer: Take care brother Wishing you healthy life. In case you need any further assistance anytime you can write to me directly. Best Regards Dr Deepak

---