Hello and welcome, You are suffering from chronic anal fissure. It is usually traumatic damage to the anal mucosa that results in a superficial mucosal tear. The management of chronic anal fissure should be aimed, firstly, to decrease the internal anal sphincter tone. For this purpose nifedipine (0.5% gel) or diltiazem (2% cream) can be applied in the anal area 3 times a day for 2 months or longer (some patients may experience mild headache after these medications). Besides decreasing anal sphincter tone, these medications also dilate blood vessels in the area and improve fissure healing. Bulk-forming laxatives and increasing fluid intake is very important to avoid constipation. Bulk-forming laxatives absorb water into the gut and makes it softer and easier to pass. Isabgol (psyllium seed husk) or psyllium powder can be used for the same purpose. Bulk-forming laxatives works fine with adequate fluid intake. You should take at least one glass of water with Isabgol and one more glass after taking it. Also increase your daily fiber intake by eating plenty of vegetables, cereals, wholemeal bread, wholegrains, oats or seeds. Topical anesthetics (lidocaine) and sitz bath - sittting in a hot water (43 °C for 20 min) up to the hips- can be used relieve the discomfort and pain. If there is an inflammation or swelling in the area your doctor may prescribe topical glucocorticoids. Don t ignore the feeling of needing the toilet. Whenever fell urge use a bathroom. Delaying may result in bigger and harder faeces formation which is more difficult to pass later. Majority of anal fissures can be healed with these procedures.