I understand how tiring repeated anal surgeries must have been for you. Since you currently have no bleeding, no discharge and not much pain, there is no urgency for another operation - a small "dot like" area after kshar sutra is often just healed scar tissue or a skin tag, not always an active fistula. What decides it is whether there is a real internal opening; that is best confirmed with a clinical examination and, if needed, an MRI fistulogram or endoanal ultrasound rather than jumping to surgery. Conservative care helps a lot in the meantime: sitz baths in warm water twice a day, a high fibre diet with 2.5-3 litres water so stools stay soft, a stool softener like isabgol (psyllium husk) at night, avoiding straining and prolonged sitting on the toilet, and keeping the area clean and dry. For the sense of incomplete evacuation, pelvic floor exercises/biofeedback under a physiotherapist works well, as this is often dyssynergic defecation after multiple surgeries. Also get a haemoglobin, vitamin B12, vitamin D, thyroid profile and blood sugar checked - your weight loss and weakness need correction with protein rich diet, and uncontrolled sugar is a common reason fistulas recur. Please seek prompt review if you develop pain with swelling, fever, pus discharge or bleeding, as that would mean an abscess needing drainage. I would be happy to discuss your reports on a Practo consult or in person at Synergy Multispeciality Hospital, Miraj.

Eat high Fibre diet Avoid Meat and junk oily spicy food Drink 3 litres water daily

Eat a fibre rich diet Avoid eggs and red meat Exercise Hydrate well and Eat more fruits and vegetables Avoid spicy fried food and junk food and avoid constipation Eat food on time

Consult your  treating doctor

kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app

Please consult a gen surgeon physically

Do consult

you can consult me and we can review your symptoms properly, assess whether any tests or medicines are needed.

in fissure surgery recurrence are very common with proper medicine and precautions it is me treatable you can consult me in procto for this

I can suggest you non surgical cures , but i need a complete detailed history of your surgeries and ailment , as a genrel surgery resident i want to help u out as much as i can.

Avoid fried and spicy food Water intake more Green leafy vegetables more Fiber meal Walk Do connect and consult Will help you

Need a few more details please consult for further evaluation and treatment

Need few more details for further evaluation. Kindly consult

Can help you, kindly consult and provide detailed history for proper diagnosis and further management