hi i had gone through your query and understand your concerns. i would suggest you taking Homeopathic medicines gives safe and permanent cure for your complaints anal fissure without any surgery along with management. the possible causes include; -Anal fissures are usually caused by trauma that stretches the anal canal, such as after passage of large or hard bowel movement or explosive diarrhea -Less commonly, fissures are caused by foreign body insertion or anal intercourse -other medical conditions such as Crohn’s disease (an inflammatory disease of the intestines).confirm with colonoscopy. treatment; i see similar cases who visit my clinic,in majority of the case the underlying cause is constipation. Usually in such cases I will give treatment for my patients in the following manner GRAPHITS 1M tid.5 days internally and calundula ointment externally then report. consult your local homeopathic physician for correct diagnosis of the case and remedy to fit your complaints I hope this is helpful for you, thank you -