Hello, I evaluated your query thoroughly. Unless conservative treatments are not giving satisfactory results or fail then and then only surgery is the last option for anal fissure, it is not the first line of management of fissure at all. I am giving my best opinions based on my sound practice to deal with these types of patients for better recovery of you without surgery till possible. Medical aspect: • Along with antibiotic, you must take anti-inflammatory agents containing non-steroidal drugs which will act both as analgesic as well as support the healing of the fissure (as example tab Flanzen D containing Serratiopeptidase with Diclofenac). • Bulk-forming laxatives as Isabgol husk to be taken 3 teaspoonfuls at night with a glass of lukewarm water helps smooth bowel evacuations and lessens the friction associated bleeding due to motions. Dietary aspects: • Consume soft light diet with more of green leafy veg, whole grains, fiber citrus fruits, fresh curd, plenty of liquids to get smooth bowel movement • Avoid all oily, spicy, non-vegetarian stuffs, chilly items at present Lifestyle modifications: • Avoid sitting on hard surfaces for long periods/long drives • Avoid exposure to excess heat • Avoid smoking/alcohol if using • Avoid stress, anxiety • Manage sound regular sleep of 7 to 8 hours Local part care: • Keep the part clean with antiseptic liquids • Sitz bath (sitting in a tub filled with lukewarm water for 10 minutes each morning, evening and especially, after passing stools) helps to a great extent and if practiced perfectly it will cure you without any surgery • Wear loose, clean, and cotton clothes Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel