Brief Answer:
need to cure your constipation first

Detailed Answer:
Hi XXXXXXX

Welcome to HealthcareMagic.

The cause of fissures is constipation. The longer the stools stay inside, the more water gets absorbed from it. Thus it becomes more hard.

When this hard stools comes out, its stretches the opening excessively, leading to a tear in it. This tear is called fissure.

So until you get this constipation cured, it is very difficult to get this thing cured.

For this purpose, I usually prescribe my patients laxatives and fiber rich diet and sitz bath (to sit in a tub of lukewarm water for 15 mins). And those who do not respond to this, I take them up for surgery.

So if you have already tried all these medications and diet modification over the past 4 years, you should go for surgery. If not tried these, then I would like you to follow this for two weeks and see if there is any improvement or not.

The laxative dose you need to adjust by yourself to have a soft consistency of stool that passes out without hurting you.

Hope I have been helpful.

Regards,
Dr. Ashish Verma

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Brief Answer:
its not painful

Detailed Answer:
Hi,

Those skin tags that has come out are sign of old healed fissures. And new bleeding is from the new fissures.

The surgery for this is very simple and you need not fear for it. The injection given in the spine is anaesthesia injection. It will feel just like a needle prick. After that you will not feel anything from your waist downwards for few hours.

In the surgery, about one third to one half of the lower most fibers of internal sphincter is cut. This will reduce tone and help in curing your condition .This will take about 3-4 days to heal.

Hope i have answered your query.

Regards
Dr Ashish Verma

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