Hi Doctor,

I got anal fissure which is coming on and off for about 2 months. The first fissure is on 18th february 2016, when I spot a bleeding when passing motion. My GP diagnose it as Acute Anal Fissure and prescribe me with dhactulose(taken 3times a day) and proctosedyl(applied in the morning, at night and after BM). The bleeding last for about 4-5 days. I have to go to toilet 3 times a day so I decide to take dhactulose only at night and slightly reduce the dosage from time to time). I have also change my diet from vegetarian to gradually add meat into my diet. It gets better for about 1 week then i get constipation and get another bleeding when having BM. I start to eat a lot of vegetable and fruit ( most of it was watercress and dragon fruit as i feel it makes my stool softer). It gets better for 1 weeks and then i have constipation again. This last one is the most painful BM that i got. The next day i have get a fever (38.5celcius). My GP don't know the cause for the fever whether it is because of the fissure from my rectal area or infected by other sick people(1kids in my house was having fever at that time). I decide to see colorectal specialist. He prescribe me with rectogesic(applied in the morning and at night) and dhactulose(10ml twice a day-although i only take it at night). As advised by my doctor, i have change my diet as well( i eat vegetable in every meal, drink plenty of water, exercise 2 times a day, decrease spicy food and heaty food).

It is been 1 months after the last consultation with colorectal specialist, it gets better eventhough i can still feel a little bit soreness sometimes ( especially at the very beginning of BM and whenever i have big stool or passing motion too fast). I still use rectogesic ointment until now because of the soreness. For dhactulose, i slightly decrease dhactulose dosage and stop taking it now.

My questions are:

What cause my anal fissure? If it is because of constipation, it question me as I eat plenty of vegetable and fruit in the beginning. Can half bar of chocolate cause constipation for adult- i realize before i get the last most painful BM after i ate chocolate? If so, does this mean i cannot eat chocolate for my entire life :( ? Will it get better? Whenever i search in google, it will appear anal fissure is symptom of cervix cancer or HPV. Is it really the cause or is it only because i keep changing my diet. What should i do? Can it be cured or will it be last forever?
Besides that, i feel stinging followed by itchy sensation around my rectal and genital area after i applied rectogesic ointment.

Thank you so much!