Can help you with the next course of action and treatment plan. Kindly consult via whatsapp at nine zero two nine six zero zero four seven zero.

Your diagnosis is Chronic anal fissure and you have undergone surgery without relief. Continuous spasms of anal sphincter decreases blood supply and causes pain. So, immediate symptom relief is with topical vasodilators like 0.4% Nitroglycerin (Rectiv) or 2% Diltiazem / Nifedipine. Applied directly to the anal canal to decrease resting pressure and improve healing blood flow. Remember, Nitroglycerin can cause headaches as a side effect. Soaking your anus area in a shallow, warm water bath for 15–20 minutes 2 to 3 times a day. This relaxes the spasming sphincter muscle and safely eases sharp post-defecation pain. Daily use of bulk-forming fiber supplements (like psyllium) paired with osmotic stool softeners (like MiraLAX or docusate). This prevents straining, which is essential to prevent tearing the fragile, healing tissue. For severe pain, apply Lidocaine around anus. This can ease bowel movements. Avoid codeine-based painkillers, as they cause severe constipation.

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Hi, Proper evaluation and personalised advice are needed for your concern. A detailed consultation would be best to provide accurate guidance. Feel free to consult me for further assistance.

Yes, biofeedback therapy should be considered if anorectal manometry confirms dyssynergic defecation.

This is a lifestyle related disease. Correct your self & it will not create so much problem.

Consult with general surgeon

Consult with general surgeon locally.

Consult

Need few more details for proper understanding of your issue. You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management

1 # Eat a balanced diet Plenty of vegetables, fruits,        whole grains, pulses, nuts, and seeds. Limit ultra-processed foods, excess sugar, and excessive salt. Choose healthy protein sources and healthy fats. 2 # Stay physically active Aim for at least 150 minutes of moderate exercise per week. Include strength training 2–3 times weekly. 3 # Maintain a healthy weight Excess body weight increases the risk of many chronic diseases. 4 # Get adequate sleep Most adults need 7–9 hours of quality sleep each night. 5 # Stay hydrated Drink enough water throughout the day. 6 # Avoid tobacco and limit alcohol Smoking and tobacco use significantly increase disease risk. 7 #Manage stress Meditation, yoga, hobbies, social connections, and relaxation techniques can help. 8 # Practice good hygiene Wash hands regularly and follow food-safety practices. 9 # Keep vaccinations up to date Vaccines help prevent many serious infections. 10 # Have regular health checkups Monitor blood pressure, blood sugar, cholesterol, dental health, and vision as recommended. 11 # Take medications only as prescribed Avoid self-medicating, especially with antibiotics. 12 # Protect yourself from excessive sun exposure

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

Consult to surgeon

Avoid fried and spicy food Water intake more Do connect and

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