Dear Zishan, Anal fissure is usually caused due to constipation and passage of hard stools. The medicines that you mentioned will give you some relief but you need to take care of your constipation. Since you mention that you having bleeding with bowel movementts and sentinel pile I suggest that you get yourself examined to rule out any haemorrhoids (piles) which may be associated. After getting a thorough examination your treating doctor may suggest you some dietary modifications which should control your problem. Surgery is the last resort when conservative treatment does not produce the desired results. Wishing you a speedy recovery.