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How to Prevent Anal Fissures

Few health challenges can generate as much pain as a chronic anal fissure. This article explains how an anal fissure develops, and how to promote healing of an anal fissure using natural methods.

What is an Anal Fissure?

An anal fissure is a tear of any size in the anus. If you've ever noticed a spot or two of bright red blood on your toilet tissue after having an uncomfortable bowel movement, you have likely experienced an anal fissure.

An anal fissure can lead to burning, stinging, or sharp pain during bowel movements. The pain can last anywhere from a few seconds to a few hours. In severe cases, the pain can cause a spasm of muscles that surround the rectum, which can cause the pain to intensify.

Fortunately, most anal fissures heal rapidly on their own. When a fissure doesn't heal within a few weeks, it's usually because one or more root causes continue to aggravate the fissure.

Root Causes of Anal Fissures

The most obvious cause of an anal fissure is direct trauma to the anal canal. Childbirth, anal intercourse, and insertion of any foreign bodies into the anal canal can cause a fissure.

Chronic constipation and chronic diarrhea can also cause an anal fissure by repeatedly straining the lining of the anus.

In the vast majority of cases, an underlying cause is chronic tension in a muscular ring - called the internal anal sphincter - that surrounds the anal canal.

If your internal anal sphincter is chronically tense, blood flow to this region is reduced. Reduced blood flow causes the lining of your anus to become more susceptible to tearing. Reduced blood flow to your anus also makes it harder for a fissure to heal.

This is why some people tear relatively easily when they try to pass hard stools, while others don't develop a fissure even when chronically constipated - the tone of your internal anal sphincter largely determines if an anal fissure will develop when your anal canal is excessively stretched.

So what can cause your internal anal sphincter to be chronically tense? In the absence of overt neurological dysfunction, the most common cause of a hypertonic internal anal sphincter is ongoing emotional stress.

Emotional stress causes your autonomic nervous system to gear up to fight or run for your life. One of the consequences of being chronically amped for a fight or flight response is a tense and dysfunctional gastrointestinal tract, which includes a taut internal anal sphincter.

Without exception, every person that has come to me looking for a way to heal a chronic anal fissure has reported experiencing significant emotional stress around the time that the anal fissure first appeared.

My experience has been that botox injections, lateral internal sphincterotomy, application of nitroglycerin ointment, and other conventional medical treatments for a chronic anal fissure tend to lead to temporary healing at best and a re-occurrence of the fissure if emotional stress continues to take its toll on the internal anal sphincter.

Natural Ways to Promote Healing of an Anal Fissure

What follows are natural ways to prevent and heal a chronic anal fissure:

1. Avoid regular use of soap on your anus

As explained in my article on why you shouldn't regularly use soap on your private parts, it's best to wash your anus with warm or hot water without the use of soap or other personal care products. Regular use of soap to clean your anus can cause the lining of your anal canal to become dry, predisposing it to tears when stretched excessively.

2. If your anal sphincter is dry or you have an existing fissure, use coconut oil to moisturize the area.

Coconut oil is an excellent moisturizer for all of your body's linings. Coconut oil also appears to have healing properties for wounds - some health practitioners in Indonesia have long used coconut oil to effectively treat bed sores and other skin lesions.

Don't be afraid to apply coconut oil to your anal sphincter several times a day. If your anus is dry or you have a chronic fissure, it's best to apply coconut oil to the area throughout the day and before you go to bed.

3. Take a warm or hot bath at least once a day.

Immersing your body in warm or hot water can help relax your internal anal sphincter, which will allow better blood flow to the area.

Consider visualizing rich blood flow to your anal sphincter as you soak in the tub, as we know that the mind-body connection is capable of producing real physiological effects. To facilitate the use of visualization to promote rich blood flow to your anus, try placing one of your hands against your perineum (the region between your genitals and your anus) to give your mind a palpable target.

4. Work at experiencing comfortable bowel movements.

For comprehensive information on how to promote healthy bowel movements, please view:

How to Keep Your Colon Healthy

5. Strive to feel emotionally balanced.

None of the above is likely to lead to lasting improvement unless you work at consistently feeling emotionally balanced.

If you're not sure where to begin with addressing your emotional stressors, please have a look at the mind-body exercises found here:

Mind-Body Exercises for Optimal Emotional Health

Although the article cited above was originally written for people looking for help with depression, the mind-body exercises found in that article can be extremely helpful when looking to feel emotionally balanced.

If you're currently suffering with a chronic anal fissure, I hope that you find the suggestions in this article to be helpful. Please note that some fissures can be caused by inflammatory bowel conditions, such as ulcerative colitis and Crohn's disease. Fissures can also develop when a person has syphilis, tuberculosis, a weak immune system, or anal cancer. Anal fissures that are caused by excessive stretching and a tight internal anal sphincter almost always occur at the north or south poles of the anal sphincter. The other causes of anal fissures listed here often cause fissures along the sides of the anus. Anal fissures are easily diagnosed with a visual examination, so please see your doctor if you are unsure about your status.


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Try raw (unpasteurized) aloe vera juice implants overnight to help heal them. It worked terrific for a chronic condition I had, and since following Dr Ben Kims advise on "keeping the colon healthy" I have been completely pain free, no more tear down there for a year and a half now. The implants took about 10 days to do the job.

My husband and I both drink alkaline water//about two quarts per day..this has healed my husband's fissure, and my hemorrhoids...due to the indrease of blood and oxygen getting to this part of the body.

What exactly is the raw unpasturized aloe vera thing?

The unpasteruized aloe vera is supposed to reduce internal inflammation and promote healing, as well as a be a gentle laxative/stool softener. You can get this in the pharmacy section of most Walmarts. I have used it with pretty good results after it was recommended to me. Be sure to make sure you take plenty of fluids and fiber in as well every day.

i think i have fissures, so painfull to go to the loo but not constipated, and pain afterwards as well, pain subsides after a few hours. its been 3 moths now

Apply coconut oil bed time and before going to loo.. thanks.. i had same problem. I am fine now.

Hi hopefully you’re healed but if not...have cleansed with saline water?

Hi there just needed to ask you that if we have to take aloe vera juice implants for lifetime of till it heals?

Aloe vera is best to drink or compress for anal fissure ?

I just wanted to add that this happened to me and my stills were large and hard. My chiropractor recommend nutritional support for my gallbladder that was not processing fats properly. It has really helped and I am feeling so much better.

What was the nutritional supposed he suggested? I don't have a gallbladder anymore and wonder if this would be of help to me. Thanks!

What will help both to improve

Great article and I wanted to let people know that I formulated a product to heal my own anal fissures and those of my readers. I specialize in natural healing methods for digestive diseases and anal/rectal fissures are very common in people with colitis, Crohn's and IBS.

These are very thin suppositories (so easy to insert in a sore anus) - because of the thin size (1/4" diameter) we have to have them handmade by a compound pharmacy - and they contain fantastic wound healers like comfrey root, slippery elm, marshmallow root and cocoa butter.

They are called FissureHeal and they work really fast. The cocoa butter base also helps to moisturize and lubricate the tissue to make your next bowel movement easier. Just Google "FissureHeal" and you'll find them - or ask Dr. Ben to carry them in his store!

Jini Patel Thompson

Great article Dr. Ben!

Using FissureHeal is a great natural option to heal the wound itself, especially if you have a fissure higher up (not on the sphincter muscle). But if you have the internal anal sphincter spasm that Dr. Ben is describing as one of the most common reasons for the fissure in the first place, then isn't the fissure likely to come back again if the spasm isn't also released?

I have this exact problem. I am suffering with a painful fissure that I have had for the last 2 years. And it is in the top position as Dr. Ben describes is common for spasms. I am grateful to this article for shedding more light into my understanding of this problem. Yes, emotional stress from disabling health issues was very high at the time the fissure occurred 2 years ago. I initially used Nitroglycerin ointment with good success since it brings blood supply and relaxes the muscle. But now the problem seems too severe for that to do much good anymore.

So, my question now is - is there a natural way to release the internal sphincter spasm for good? Clearly creating ways to manage and decrease emotional stress are key to prevention, but it's been 2 years and that muscle is locked in a spasm pattern, even when I have little stress. Taking epsom salt baths has certainly been soothing and sometimes relieves pain temporairly, but it has not been enough to stop the chronic spasm.

The doctors say surgery is my only option, where they go in and cut the sphincter muscle to release the spasm. But I wonder if cranial sacral, chiropractic, osteopathy, and other bodywork might be able to release a sphincter spasm more naturally? Are there other ways to release a chronically spasmed muscle? Can these methods work on the internal anal sphincter muscle?


Hi Danielle, were you able to get an answer to your question about healing spasm naturally, w/o any surgery? i had the same issue you had and my fissure sits in the top position not in the sphincter muscle. I really hope someone can shed a light to this, because i am desperate to get answers to this problem.

please respond,

Is this a tear on the skin south of the vagina? I have several tears in this area that have made skin tags. And its very painful.

Anal fissures are in the rectum/butt area.

Thank you Dr. Ben for this article! It explained my symptoms very clearly.

I have been suffering for more than a month with AF but did not know its AF and thought it is hemorrhoids. Finally when I understood what is internal sphincter muscle, I used marjoram, myrrh and peppermint therapeutic grade essential oil topically and as a suppository made in coconut oil. It's a miracle relief! Hope this helps.

Best in health!

what did you mean about the coconut oil suppository for the anal fissure.

What is "fissure heal" you are talking about here when you say, " FissureHeal is a great natural option to heal the wound itself"? Is it a cream?

FissureHeal is an anal suppository. Used mine for 3 days and it seems to be healing my fissure.I can now enjoy spicy foods again. Overpriced but seemingly effective.

I had a severe fissure after childbirth and even though it was mostly healed my sphincter would still go into intense spasms lasting most of the day! My Naturopathic doctor offered to do neural therapy injections in my low back. I was very skeptical that after all I had tried this would do anything to help. Withing 3 days I had my first pain free day! My healing was quick after that! I went in for a follow up treatment and was soon pain free :):) Neural Therapy works to 'reset' the nervous system allowing all of those muscles to relax and almost clearing away the memory of the trauma!
I tried almost every trick in the book and this was a miracle cure :)

I wish to seek a naturopath in the Boston area who could do the same. How do I find one?

Hi, my doctor also offers neural therapy but she hasn’t offered this to heal the fissure yet. I’d like to discuss this with her and share your success. Was this injected into the right low back muscles? Which ones? How many injections were done?
Also,what is the name of that doctor? I’d love to see them. Thank you! So glad you healed; I’ve been battling this for 8 years and hope neural therapy will fix it!

I am suffering with anal fissure and have tried everything natural that I read about without much success. I have better days and bad days. I am trying to avoid surgery and wonder if you can tell me how you are doing and if you managed
to heal naturally? Any information is greatly appreciated. Thanks! Robyn

Aloe vera gel works I have been using it hasn't healed all the way yet ,but pain is good and can like life a little better.

Dear Thompson.
I am living in Saudi Arabia, I have the same problem of Fissure, I tried here to buy, not available. If you can help me to buy this, it will be a grateful. I am ready to buy either credit card or paypal. Thanks.

I just want to share a helpful tip I learned many years ago. If you've gotten an anal fissure, for whatever reason, there can be continuing pain or discomfort during bowel movements while the fissure attempts to heal. Just before a bowel movement, lubricate the anus with a small amount of vaseline. This eases the passage of stool and also helps with cleanup, which can irritate when the area is extra sensitive due to a fissure. A bonus is that knowing things will "go more smoothly" eases tension as well!

I agree; this does help "prep" things for passage of a stool. It lubricates walls and can begin to push back on constricted tissues and muscle so that the stool itself (particularly if the beginning section is drier or more compacted than the rest) doesn't stretch/tear everything in a dramatic push. I use a less greasy/creamier lubricant than vaseline, however.

instead of applying vaseline before the bowel movement, apply it after wiping/showering - it will gradually work its way deep into the anal canal as you walk around, and seems to stay lubricated for a long time, making the next bowel motion very easy.

I had a very difficult labour and delivery with my first child and developed a fissure which unfortunately also became ulcerated, leaving me in extreme, constant pain (not just pain at the time of bowel movements).

I had a very kind doctor who gave me a steroid cream, which helped a bit but never healed the sore completely.

After much research I found a treatment that worked so rapidly and effectively and gave relief almost from the first application:

1) Apply a mixture of olive oil with basil oil after each bowel movement. As uncomfortable as it sounds, it's very important to get the oil INSIDE the anus as the reason fissures heal so poorly is because they are constantly subjected to leftover fecal matter after a bowel movement.

The basil and olive oil mixture seem to give some numbing effect and pain relief. The basil oil also provides antibacterial properties that are important in keeping the wound clean which aids in healing.

2) Apply a small amount of Manuka honey in the morning and before bed, again INSIDE the anus. If you only apply it to the outside, it is not going to reach the fissure and heal it.

Again, Manuka honey has antibacterial properties and wonderful wound-healing properties.

After suffering with this for months after the birth of my baby, I healed myself within a about a week of this regiment. Avoiding constipation is also very very important, as I believe the area where the fissure was will be delicate for some time and may be susceptible to developing another fissure.

I hope this helps someone with this truly painful condition.

Hi Kate,

Where exactly is an anal fissure present? Is it just just about 1 inch into the anus from outside? Or can it also be deeper inside (say about 4 inch)? I'm asking this because I'm not sure whether what I have is an anal fissure or probably something else.

I've been using a prostate massager for a couple of years now. My massage session is usually less than 30 mins. But I recently had a few long sessions (about 2 hours each for 4 consecutive days). I think this would have caused some injury resulting in mild constant burning pain (though I don't bleed). Can I apply the oil you mentioned deep into my anus?


Hello Kate--I am curious as to the mixture of olive and basil oil. Is it equal amounts or what? And what kind of Basil oil? I have a 1/2 ounce bottle of Sweet Basil, which says it is 100% Pure Essential Oil, for external use only. I am wondering if that could be used inside the anus. And I do have Manuka honey. It is delicious. I haven't used it as you described, but I very soon will.

Today I got all the ingredients that you have suggested and have started your suggestion hoping to get relief. I have had this internal fissure for two years now and am trying this as last resort before surgery. Yesterday I only had the olive oil, I used it and was surprised the relief I got with that alone. Thank you for this help I am hoping I will be able to report success as I have been in terrible pain for along time, my pain tolerance is quite high, I keep hoping that what the doctor said "about 95% of people heal with a high fiber diet" will work, but as you can see that is not looking good. I could never keep the stool soft enough to let it heal. I am now doing your suggestion and on a daily dose of milk and mag. Wish me luck ;)

Julie, saw your comment and I am in the same boat. Did you have the surgery or did the basil/olive oil mixture help you? Would be curious to know after 2 years or more of your internal anal fissure did the surgery help if you had it? Am scheduled for 1/31/12 surgery, and sure would be curious to know your situation, especially if you had the surgery after 2+ years. Thanks much.

I am scheduled for surgery on 02/03/12. I would really like to know how you are feeling afterwards. The doc told me a few days of recovery but some sites I have gone on have had people talking who had the surgery said it was more like 2wks, 1 guy even said a few months and then the fissure came back. I am very nervous but have had server pain for a little over 2 months now and I am ready to get back to normal, ya know...good luck

Hi Kate,

I am suffering from anal fissure for the past one month and the pain is unbearable. I would like to try this Manuka - Olive - Basil solution that you posted here. But could you please clarify :

1. What is the proportion of these 3 ingredients ?
2. Which methode did you use to insert the mixture inside the rectum ?

Greatly looking foreward to your reply as you can very well relate to my pain... :-(

God bless,

Drink warm water, take lots of veg, if its itches pls ask doctor to which ointment should use and if pain is more pls use Suppository.. better not to take red meat for few days.. best of luck.

What is manuka honey??? Any ordinary honey can b used????

The combination on olive oil with basil and manuka honey worked really well for me.

I had been suffering from a fissure on my anus for 5 years. Now and again after an uncomfortable hard or dry bowel movement it would reopen accompanied by an intense stinging pain. It just never really healed properly.

I used 100ml of extra virgin olive oil mixed with 30 drops of BASIL (Ocimum Basilicum, from India) 100% organic essential oil, and applied as Kate suggested. In the morning and night I used Ora (brand) Manuka honey, I chose the UMF 20 product. The basil and the manuka honey were expensive but I purposely chose the highest quality options I could find. I did this because I wanted to make sure if this treatment can really work. I did not want to leave any doubt in my mind that the treatment 'may have worked had I bought better quality products'.

I do not know whether I mixed the basil/oil in the right proportions, nor do I know whether a cheaper manuka honey would have worked.

What I do know is that amazing results have been produced in 10 days. I cannot see any trace of the fissure anymore, do not have any pain when pooping, and no more bright red blood on the toilet paper.

I am so grateful to have this fixed.

Great Post! I think virgin olive oil has a lot of healing properties in it. I was suffering from anal fissures and had been checking various internet sites.All of those made me feel more negative and scared about my situation. I was very sad and helpless when one of my friend recommended me this method of water therapy. What you need to do is to consume 1 litre of water in the morning after you wake up. Do this before brushing your teeth. You have to wait for 45 Minutes until you have your breakfast/ morning snack. You have to make sure to keep this gap. Also, before drinking the water, have a spoon of olive oil mixed with lemon juice in equal prportion 1:1. It started working brilliantly with me. I was also suffering from a very bad constipation. On the second day that i followed this therapy, i excreted something as hard as a rock (It must have been the feaces that had been unable to come out for so long due to constipation). I also made some dietary changes and included more fresh fruits and vegetables in my meal. I cut down on junk food and soda intake and also in consuming pasta and bread. I started eating food rich in fibre and whole grains. I think anyone of you suffering from fissure should try this. The olive oil and lemon juice will lubricate your intestines and make it easier to go. Also increasing the intake of water is very beneficial. I hope this helps. Please stay positive because that is the key to healing. Donot fill your mind with negative thoughts as it will only drown you out.

Hi Mark,

I came across your post here when I was in agony with Anal Fissures caused by allergy reaction to medication (leading to irritation) in that area.

After reading your remedy and another person on the internet, I have combined your remedies and after 3 days I feel relieved. His remedy was ensuring soft stool using different vitamins and Vitamins for skin healing, antioxidants (internal changes) and in terms of your suggestions I wasn't able to get the Basil oil so I used Anusol cream instead but used Manuka honey (8+) morning and evening.

I just wanted to say thanks for posting this, you have saved me from this issue becoming bigger than it needs to be.

Ps. GP and general medicine is quite useless and most people suffer long term because DR's do not know natural healing methods.

Thanks Mark for sharing your experience.

Please clear my 2 points.

1. what quantity (in terms of drops) of mixed oil (Olive + Basil) we have to take at one time and how many times a day we have to apply it?

2. Is this necessary to use Manuka Honey. Is mixed oil (Olive + Basil) is not sufficient?

Please reply ASAP.

Thanks again..

plz provide link for ora brand manuka honey

The major brands here should be reliable:

Where did you buy the basil oil?

Basil oil found in my country india.its produce by a small plant.and indian worship this plant.

Hi there...
So.. I've had these fissures for years.. But going through a stressful time right now and so it causes them to inflame and it seems to have developed a few more :( It so hurts and very uncomfortable...
I saw a lot of posts about using this remedy and went out and bought them. Just started today. Ugh... Just so painful.. :-/
I'm all about natural remedies and healing, so hoping this works!
Also, it's really hard to get inside. It's so tight and sore.. Maybe tomorrow will be easier.

I would get so stressed I would be constipated for days. I started using my mind to concentrate on my tail bone area and just breathe.Often during the day i would get lost in thought or duties but i frequently would go back to breathing and concentrating on my tail bone area. after a few days i would have a bowel movement. So whenever I get that stressed I go back to breathing the area and now it only takes a few hours to have a bowel movement. Later on I learned to drink a few glases of water during the day, not the usual 8 glasses recommended but enough water to get the flow of bile moving.This method always works for me. I think the concentrated breathing increases blood flow because when i was younger and I wanted to get my menstral period over faster,like before an active weekend and I knew it was about time for it to come I would breathe in the lower stomach area and my period would begin some time during the day I chose. It was so convenient to use this method & not have to wait till my body decided to have the period.

Hi Kate !! Read your post and seems very interesting! I live in India and just had a baby 9 months back. And I have all the symptoms of anal fissure :( I did go to my gyno for it. She had a look but from what I described she said I must be having a tear due to passing hard stool. She gave me 2 ointments to apply for 5 days and a laxative to soften my stool. It did help , but I'm still not feeling 100% and keep having a nagging feeling down there.
I just bumped into your post and have read people have benefited with your recommendation of basil oil , Olive oil & Manuka honey treatment....Being a mom is a super hectic job in itself, and I blame the emotional stress ,lack of sleep and being unfit and not eating the right diet the cause of this!!!
My question to you is: did this treatment give you a permanent cure? It's been 2 weeks since I've been in discomfort , but it's scary to read many articles on the Internet .. I felt a good vibe reading your suggestion. Also it would be great if you could mention what kind of olive oil (will cooking oil do?), and what kind of basil oil? And lastly if your post has helped so many I'm thanking you already, because I'm definitely going to try it out! Regards J

Where can you buy manuka honey?I have been suffering an anal fissure for 4 years and can't find the best treatment.

Manuka Honey is a product of Australia and can be purchased on Amazon or Wegman's grocery stores and good health food stores.
It is more expensive than regular raw honey, but its healing properties are amazing. It can be used for healing open wounds/sores anywhere in or on your body. It can be covered with a bandaid where applicable.

Hi Kenneth,
You can get the honey on but its not cheap its like$29 for 500g.
Hope this helps.

Hi Kate , I was reading your post and saw the ingredients you used. What brand manuka honey did you use? What brand basil oil and what brand olive oil? I appreciate any info on that regime as I'm suffering from anal fissures atm and want to try the Manuka honey

Thanks for this great tip. After suffering from fissure for over 1 year , and trying multiple meds, finally Manuka honey concoction worked along with forces of nature, fissure control oil. Took me atleast a month of using it 3 times a day . It’s a miracle!!!
Thanks a ton.

I'm suffering as well. I'm going to try this concoction. I'm allergic to the prescription, that my doctor prescribed.

I read this today..and after 3months of pain went and bought the basil olive oil basil oil one hour later relief....thankyou..have been using nitro/lidoc...thankyou again...

Hi Debra Rankin, just want to know what did you used to cured your fissures

Please do not take baths daily. It wastes water, one of our most precious natural resources.

I need to bath daily for my health. I let the water scent and humidify the house before and after my bath, and sometimes I leave it in the tub overnight to keep the room more humid. I usually do not fill the bath totally full, and would use more water in a shower. It is either be healthy,or conserve water for the world.

For those of you who take daily baths and have chlorine in your water supply, the effects of the chlorine (highly poisonous) will negate the effects of the healing of the bath.

You breathe the chlorine directly into your lungs and blood supply. It's far more than you would ever get from drinking chlorine in your water.

Install a chlorine filter.

Oh, get off your high horse! Those that suffer from anal fissures need to use every technique to alleviate the pain. I thought this forum was for assistance, not criticism.

I agree, if you have had an anal fissure you will know how painful this can be, and sometimes the only relief you can get is in the bath. I have been known to have 3 a day. I love the planet but can't do anything if I am in total and utter pain.

Seriously, if you had an anal fissure you would care less about wasting water. And besides its not wasting it, it is what we need to do for some relief of the agonzing pain. Get off this site if your not pro healing

Although baths are recommend, they just aren't convenient. First I tried sitting on an ice pack at my desk (I work at home thank goodness!). But I found sitting on a heating pad worked better. Like any heat/cold therapy it's recommended to do 20 minutes on and 20 minutes off. It's great because it allows me to work or just relax while I sit. If the sitting pressure gets to me, I revert to laying on my stomach on the coach or bed.

Like others, I'd love to hear about anyone's experience with the surgery.

Lot of interesting information here...Thanks to everyone for contributing.

I have fought with this since I was 15. Now, after 2 babies, I am in so much pain after each bowel movement. I literally almost cry when I feel one coming on because I know I will be in agonizing pain for hours and hours afterward. About 3 years ago I had the surgery done and let me tell you, I was in so much pain afterwards!! I will NEVER do that again. It did help temporarily and if my doctor would have told me that it was not a permanent fix, I would have never done it.
My gallbladder decided to quit and I actually was doing good because of loose stool but my newest son is 3 months old and my problems are back!
I am currently breast feeding so I really do not want to use the stool softeners. I know I really need to up my water intake because I am sure that baby is taking every drop that I am taking in... I am at my whits end though. I bought cocoanut oil today (actually bought it for baby's cradle cap) but may be using it myself! The doctors have prescribed the ointments and steroids but I never thought that they worked.
If a person has never experienced this, they have NO idea the pain! My husband does not understand why I can't set still or concentrate after a BM.

Your article made me realize why my private area was bleeding, when my doctor only prescribed ointment for it, probably because he didn't know that I clean that area vigorously with bar soap daily! I've been suffering for years without realizing why! This information is a godsend.

This is an excellent article on the causes and ways to naturally treat and heal anal fissures.

I have to say, I tried this suggestion and I am on day number five. I have the basil oil being sent to me so I have not yet been using it. I mixed Manuka Honey and olive oil and inserted this into the rectum as I have an internal fissure. The results have been wonderful so far, I have experienced an extreme difference. The nagging itching and soreness has seemed to let up. I have been eating a high fiber diet, lots of brown rice, Yukon Gold potatoes and fresh veggies with ground flax seed and italian dressing. I have been using laxitives and stool softners as it is important NOT to let the stool get large or hard. Loose or soft is the way you want to go until this is healed and you may want to continue this so it does not reopen or form another one. You will notice when you insert this mixure your body will want to reject it, I kept putting it in until this stopped or got better. I hope this will help someone else who is experiencing this similar pain, I have been dealing with this for two years now and am trying anything I can to avoid the surgery. Good luck to you ;)

I think i will try this approach. I have been suffering for over 2 years now. I have had 2 MRI's to make sure nothing else has been going on. I have recently discovered i had an anal abscess, this is what has caused the most intense pain i have ever had. After 2 operations in the last 2 weeks the pain is better but i am still left with this fissure. I am having homeopathy treatment and reiki to help with the healing. I will let you know how it goes. I dont think people fully understand how painful these things are! ;0)

Hi-I have read some wonderful ideas in this forum and my heart goes out to any and all who have suffered from this horrible situation. I have had a chronic fissure for 8 months and the first five were awful! The pain was extreme and I thought I would never live a normal life again...until I found wheatgrass. If you get wheatgrass, the superbalm from Dr. it does help. It may not heal the fissure completely however it has enabled me to live a normal life again! I noticed within two weeks I started feeling better and if I can help anyone through this terrible suffering, I will. I also found that magnesium assists in softer bowel movements as well. If you want assistance and or need someone I would like to tell you your not alone there is hope for this.

I had an anal fissure for 2 years, after a colonoscopy. I asked another surgeon what i could do, and he did a manipulation anally, with some tools, and it healed in 2 weeks, as it is supposed to do.. I asked what he did, and he said "NOTHING" , so I guess it is a secret.. .. mary.

Who is the surgeon you mentioned, and where is he located?

Did the colonoscopy cause the fissure or detect/ diagnose it?

I also have suffered from anal fissure for a few years, on and off, and tried pretty much everything you can find online. I stumbled upon Dr. Wheatgrass cream and thought this would be the one I would try before surgery. Surprisingly, when I visited my doctor after a week and half, she said I no longer needed a surgery since the fissure was almost healed. I was soooooo happy and thankful. I stopped using it after all my pain went away but still keep the wheatgrass cream around and apply It whenever I feel it might be coming back. I never ever want to have fissure again! I hope this helps.

How's the honey and basil going? I ordered both from Amazon. I too have an anal fissure, 6 months now. It's slowly gotten better (measured by months) but still not healed. Is it working for you?

I realize everyone is different but in a desperate move I tried the Manuka Honey and olive oil route and it made a difference. I had had nifedipine cream, diltiazem cream, two botox procdures and was not healing--constant bleeding, weeping, and burning/irritation. Doc couldn't figure it out. Put me on flagyl. Thought it helped at first but no. Doctor wanted to try another surgery by grafting tissue from an adjoining area--I balked--at least for now--if i'm not healing in that area why open an adjoining wound? So I bought a jar of Manuka honey 400 from Manuka Health (the 400 is the strength, there are two or three different ways --and some controversy--of measuring it and lots of fake stuff out there, but that's another discussion). I applied it internally coated with olive oil morning and evening and almost IMMEDIATELY felt some relief. Although the actual insertion did trigger some mild bleeding, the pain started to subside almost immediately. I stopped a week ago because of the holidays and some traveling. I still feel a little occasional mild irritation down there so am not completley healed (yet) but have had no bleeding and no weeping and feel better than I have in about a year. I'm going back to the doc next week and may do another course of this between now and then. Now to be fair, I have also been dosing with some high count probiotics so that may be a factor as well. But as I said, everyone is different but I think the failure to heal on my part was due to some bacterial or fungal imbalance that the honey is helping with. I've also been eating it--tastes great.

After using the Manuka honey and oil remedy as mentioned by Kate and a few others my fissure seems to have cleared up completely after 3 years and no medical improvement.
However I still can feel spasms quite regularly- which the doctor can see - and was wondering if anyone could suggest something to help stop the spasms so I can be free of this worry of tearing again?

To calm your sphincter spasm you can use clove essential oil diluted in olive oil. It will give you relief and you also need to increase blood flow back in this area. A heating pad will help

Hi everyone. Could you please tell me whoever used the Manuka honey and felt better, how are you doing now? Did the fissure come back after the treatment? I guess it is important to take the strong Manuka, as i have been using Manuka +10 for the last week, it is helping me, but i still have the fissure.

I've been reading all the posts, and would like to try this remedy, but I don't get how you insert the liquid into the body. Right now the combination of hemorrhoids and fissure is so painful I can't imagine getting anything into the rectum. What do people use?


I appreciate both the post and the thoughtful comments.

I wanted to share an experience I've had and hopefully it will help others. I was taking a "powdered" supplement in a packet which I would dissolve in liquid. I believe it was EmergenC ( I can't remember the flavor) and while I was using it I had anal bleeding and fissures. I soon stopped taking the powder and the bleeding stopped as well, followed by the fissures healing. I suspected the bleeding may have been caused by the powder but I wasn't sure. Then time went by and I forgot about the connection. I took some packets with me on a trip abroad and after using less than a couple packets, the fissures were back. Finally, the connection was solid in my body and mind. I don't ever use those crystallized supplements now because I believe either the crystallization catalyst is still there and causes crystals to re-form, or they are never completely dissolved. At any rate, I believe they are harmful to skin tissue. I would use a small amount of zinc oxide on a Q-tip to clean and speed up healing of the fissures—gently press the head of the Q-tip to the inside.

Recently I discovered an outstanding coconut bar made by Oskri—Coconut Bar Original. I love this two-ingredient bar (coconut and a small amount of rice syrup). Eating at least one a day greatly improves the texture of my stools which tend to be dry or hard.

The crystallized supplement sounds like it was Vitamin C and that vitamin acts like a blood thinner, making it easier to bleed heavy after a rough bowel movement.
E is a blood thinner- Flaxseed- Olive Oil-Lecithin-and others. You really need to see if you are taking any vitamin or supplement that thins the blood( your cholesterol test will look great but you may need to drop the amount down if you see a lot of blood in the toilet bowl.)
Aspirin- alone or in something like EXCEDRIN! Things we may not think about as we take them, but can be blood thinners.
The blood we see passed with a fissure or even a hemorrhoid can be frightening....and even more so if you are on a thinner for blood clots or the above mentioned examples.

Stopping taking the Emergen-C supplement would show improvement because of the drop in vitamin C levels.

I had anal fissures BIG TIME! extremely painful. The doctor gave me something on prescription that was Vaseline based. The pharmacist had to order the powder to mix into it.
Turns out it is Cardazam/(Diltiazem), a very powerful drug used in hospital to treat my atrial fibrillation. I thought it was extremely weird to put this heart drug on my fissures, but it worked within days after months of suffering. The quantity was just 0.2%

I had an anal fissure after I had my son 8 years ago. It was super painful. It healed after a few weeks but the pain did not go away. Had another fissure along the way with continued pain.I went to many doctors over the next year and a half or so and they made me feel like I was crazy to continue to complain of pain when they said it was healed. They had very little to offer but the regular mantra, take fiber, take baths, etc. I had the surgery where they partially cut the internal sphincter muscle to help relieve the spasm. I still had pain. I finally found a colorectal dr. that had the newest treatments. He also prescribed the cardazam 0.2% cream. The prescription cream has to be made by a compounding pharmacy. It was like a miracle. If your dr. does not or will not prescribe it or hasn't heard of it go to another dr. I honestly think that if I had seen this dr. earlier,I would not have needed the surgery.

Hi thanks all above for the great discussion and tips. I will be heading out to get some manuka honey today. Just wanted to add a couple of things I have done in the past. Number one and even more useful for hemorrhoids is an anti-inflammatory medication called Diclofenac. Not ideal to be on long term but reduces or entirely ends the pain within a couple of hours and can be a godsend whilst trying to get the fiber and healing process sorted. Number two - this is weird but again very helpful with hemorrhoids; when you are on the toilet and about to poop, put your hands on top of your thighs right by your hips and push your shoulders up and also try to suck your stomach up as much as you can. This pulls the anal canal upwards a bit like pulling a crumpled tube straight and can allow the stools to almost fall out without straining in the slightest. Well thanks and good luck. gives a whole new meaning to 'Pain in the Ass' aye!

I just picked up my cream today. How long did it take to heal yours with the cream?

I've found this article to provide welcome information to several of my co-workers (5 had already had surgeries). They thank you for that.

I was also wanting to find out the date that the article was set out by newsletter. I had nostril lesions at the time and am trying to attach a length of time of these nuisances.

Please, DO NOT put basil oil anywhere near your anus. Although basil oil has many healing properties as an essential oil, it is NOT recommended for topical use. It is CERTAINLY not suitable for an open wound! The skin around the anus is thin and very sensitive. A 'tingling' sensation will be indeed felt, but will likely result in an infection or skin rash. As for the honey, save it for your toast!

where did you get the idea it can't be topically applied?!

Do not agree at all. Manuka and oil/basil combination worked wonders for me. I have written another comment already in reply to Kate's post which gives my detailed experiences.

Hi i just read this whole article over.

From what i read these are the remedies suggested:

- Unpasteurized aloe vera
- "FissureHeal"
- 0.2% cardazam
- Manuka Honey/Basil/Olive oil mixture

I am hoping that any of these work for me as i have had an anal fissure for 6 months now after the doctor cut out a very hard protruding polyp that popped out of my anus while studying. He did not stitch or cauterize it when he was done.
Currently all the doctors i see about my problem just say its a hem. I have so much rectal bleeding each time i have a bowel movement and the reason is not how hard or soft my stool is. The reason is simply because the anus has to expand each time. Imagine your anus is a balloon with a tear in it. When the balloon is expanded with water, the slit opens up wider and water (blood) gushes out. When you are done pooping, the anus gets smaller and the wound trys to start to heal (just like the slit in the balloon shrinks after all of the water is emptied from it and the slit is much smaller or not even noticeable) But! if every day you are streching the wound open again, it can not heal! And its worse if you are rubbing poop on the wound each time.

While i really want to believe that all of these "creams" will essentially work (and i hope to try them, i have only used Vaseline and it didnt stop the bleeding), I am a firm believer that physical intervention is much more effective.

I am not proposing surgery however.
I am proposing that somthing like a balloon (or tampon) in the shape of an egg beater (but much smaller) help keep the anus open. Think about it, if the anus is stretched open then the blood can clot when the wound is at largest and exposed to air, then the wound can actually clot and heal.
The problem with this method is that your anus is hard wired to want to push out and it would be hard to keep something like that in fora longer period.

I wish there was one definite solution because i dont want to go years with having this.

I have had this problem for the last two years. It got really bad a two months ago. I seen the colon rectal surgeon. She gave me a prescription to put inside that lets your blood flow better
to the area so it can heal. If this doesn't work she is going to give me a botox injection. She said surgery is the last resort because it can cause anal leakage. I have fybromyalgia and have had a problem with constipation for years as well. I think they have both contributed to my problem.

I have been suffering with annul fissure and 2 hemorrhoids for over a year. I just had the Botox injection about one month ago and along with the Nifedipine .2% in white petrolatum top oint prescription cream it seems to finally be working. I also sit on the toilet in a warm "sitz bath" tub device once or twice a day for 15 -30 minutes (so this minimizes water usage) and you can relax and read a good book. I also use Konsyl fiber about 3 times a day to soften my stools.

My situation was an anal fissure that kept reopening on every bowel movement. Even after a year of following my doctor's advice of high fibre diet for soft stools and muscle relaxant cream, it still split on most bowel movements.

The solution that worked for me was to progressively gently massage the inside of my anal ring during my daily shower (no soap), working towards comfortably being able to insert two fingers (similar to stool size) just past the inner ring, and rotating them.

Over three weeks, this seems to have rebuilt up my lost natural elasticity in the scar tissue on my anal ring. This same technique had previously worked on a long term recurring split lip I'd had many years ago.

I wish doctors in the UK had better means of sharing patient solutions, like on this forum. I have a feeling GP's will be replaced by an app at this rate.

I have been dealing with a anal fissure for 2 years, tried several Otc meds. Have had some relief but slight constipation always makes it re-occur. Lately I have been using organic Aloe Vera gel in its purest form possible, and am feeling very little pain. It's been about 4 days so far and seems to be working. I ordered Aloe Vera gel, about $17 by mail, put a little in an ice cube tray , freeze it , pop it out, let it melt slightly, maybe 2 minutes so it won't be so cold, then insert it. Use it as often as possible .
That's it. Good luck.

I found that one of the easy things to do is to keep a small child step-up stool in your toilet and when you need to pass a motion put your feet up onto the stool and sit back with a straight back when on the toilet seat, never lean forward as this restricts the bowel passage. Also RELAX. I am only 5ft tall, and so a foot stall is the best. Also keep a big bottle of organic shea based lotion with a pump top and spread a little of the lotion onto your loo paper to prevent a sore bottom before exiting the toilet. Also drink Kambucha and eat only non processed foods from nature.

I had horrid, painful, debilitating rectal fissures for almost two years, and I finally healed them by doing these five things:
1. Because animal fats turn to acid in the digestive system, and therefore irritate the open wound of a fissure, I stoppped eating all animal products, and went on a vegan diet for 6 weeks. 2. I had thought that squatting was best for defecating, but instead I leaned back, which no longer put pressure on the fissures. 3. I made rectal suppositories by cutting small pieces of aloe vera plant(just the inside of the leaf-not thte green!), and freezing them so the'd be firm enough to put inside, did that every night at bedtime. 4. I applied Coconut Oil every morning & night. 5. Visualization: at bedtime and in the morning I visuallized the fissures closing up, and the cells growing back together....I had been on the brink of going in for surgery, very depressed, but by doing these things religiously for 6 weeks, I am completely healed, Yay!!! My doctor was amazed, and wanted to know the tricks!

Do you put the aloe vera all the way in small pieces.thank you

I have suffered with Anal Fissures for around 8 months following a nasty virus which gave me diarreah. I initially had blood then I began to experience sharp pain during any bowel movement followed by hours of pain during the day. This is a terrible condition and I fully sympathise with anyone going through any part of what I have experienced during the last few months. Initially I went to a private doctor, who prescribed me GNT ointment, which gave me a headache once applied to the anus. This helped a little with the pain, but not much else. 6 weeks later I was prescribed another ointment which actually worked to some extent - pain started to dissapear. At the same time I hit on a very stressful work period - I was overworked as well as worried over my business, which brought back the anal fissure issue. The doctor didnt think the two were linked and encouraged me to continue with the ointment. After some more time I gave up on the ointments from the chemist, concentrating on more natural methods. 10 days ago I started a new regime which is working wonders so far. Most of this came from this site - so i thank all who have contributed. I will describe my regime, please feel free to ask me any questions.

1. At night around 8PM I take prune juice, a laxative, magnesium tablets and some water. this helps the BM in the morning.

2. Before I go to bed I apply Manuka 15+ to my anus - in, inside and around it, up to my second knuckle (gently and slowly obviously, and sorry for the graphic description) Clean up any excess before getting in bed!

3. First thing in the morning, back to the Manuka, in and around! With me, this stimulates a BM within 30 mins. This has got progressivley less painfull every day.

4. I nuked some coconut oil (a quarter of a small jar) added 100ml of virgin olive oil and 35 drops of basil oil (essential oil grade) then froze it in my freezer. After every BM and at intervals during the day I break off small shards of this (about the same size as the end of your little finger) and use it as a supository. You have to be fairly quick in inserting it as it melts very quickly.

5. 2-3 Sitz baths every day

6. Meditation / Visualisation

7. I work on a non processed food, paleo based high fibre diet where possible.

This is WORKING for me, it has gone from most of the day pain to morning pain only, and getting better every day. I am not out of the woods yet, but I am very sure this will work if I continue.. I will keep the board informed of my further progress if anyone is interested. I also have an appointment with my doctor on the 11th August where I am going to explain my regime and I am looking forward to his response!

Good luck to you all!

I have been at the point of not wanting to eat for fear of having to use it later and experience the blood, throbbing pain and severe discomfort caused by my fissure/hemorrhoid. I have been praying and praying for healing and I believe I have found a remedy. At the very least I have some serious relief from this debilitating pain. Thanks to Dr. Kim and those who have offered advice, it has helped me tremendously, I mean that.

It takes a bit of work, but that is a small price to pay for good health.
First, your diet must improve. Water, fresh fruits and vegetables, beans, nuts and seeds, etc. should be staples of your daily eating regimen. However, that is not enough on its own if you have a fissure or hemorrhoid. I began taking sitz baths twice a day, and that helped a bit but not as much as the following, plus I began to break out with heat rashes from the very warm temperature.

Every morning I squeeze one half of a fresh lemon and mix it with one tablespoon of extra virgin olive oil. I do this early and don't consume anything else for at least one hour. Afterward I eat as I would normally. Before bed I take 1/2 tablespoon of extra virgin olive oil. This seems to help my constipation issues more than anything else I have done, and I have done a LOT.

Based on the advice here I also began to grease my rectum with olive oil, manuka honey and basil oil. However, initially, I was in so much pain that it hurt to even touch that area much less actually insert my finger somewhat. However, the ingredients must get inside of you to work. This mixture was very liquid so I refrigerated it to solidify the olive oil a bit and it became a bit easier to apply. After a day or two, I had a bit of relief and attempted to make a home made suppository using this combination, but it did not work. Even freezing it was ineffective because the olive oil is too viscous. I then switched to coconut oil (Nutiva: virgin, unrefined,cold-pressed) and achieved the desired results. Mix about one tablespoon of coconut oil, 1/2 teaspoon of manuka honey and four drops of basil oil together (this is not an absolute formula, but it's what I do). If the coconut oil is solid, heat it over a double boiler, it liquefies very easily. However, it will not blend with the honey and basil oil in a liquid state. As it cools and begins to harden it will become the perfect consistency to mix everything together. Tossing it in the fridge for a few minutes will accomplish this. I then made my own suppositories using baby bottle nipples and pacifier nipples (they sell suppository kits, but I wanted to save some money). Put the nipples in an ice cube tray and put the mixture into the nipple portion only (the narrow end). Toss them in the freezer and you have the perfect suppository for healing a fissure or a hemorrhoid. Insert one every night before bed.
Now, in doing these things you may feel the urge to go right away, but your body is healing itself and those muscles that Dr. Kim spoke of in the rectum are beginning to relax. Your bowels are also turning into the proper consistency. Be consistent with these steps, especially the olive oil and the good diet.

Praise the God of Abraham, Isaac and Jacob for the unspeakable, humanly incomprehensible wonders of His creation, and thanks to all who have offered advice on this very sensitive subject.

I had this problem while on vacation and nothing seemed to help until I took natural Vitamin E. It worked like magic. In less than two days the problem disappeared.

To get rid of Hemorrhoids for ever, Take, Rutin (a vitamin) with vitamin C..If you take it everyday, you should Never get Hemorrhoids again..
Btw check out on Google about Rutin..

Take Care.

Any good for Anal fissure?thx

If I eat 1 to 2 cups of peaches, canned, three to four times a week with breakfasts or 3/4 to 1 can of turkey chili for lunch a couple times a week, along with getting a sufficient amount of water without overdoing it, the bowels will move like they are supposed to. Eating wet fibrous foods such as peaches and eating chili with beans for lunch twice a week, which is also a fibrous food, there is never a worry that the bowels will not work properly. I include eating one to two cloves of elephant garlic 4 to 5 times a week with breakfast and then wash the odor from my hair and body and put on fresh or non-garlicky smelling clothing so I won't stink others out, fried on a gentle medium to medium-low heat until lightly golden brown and softened, as it helps to heal the stomach and helps built up gases come out. Some call the "farting" from garlic an allergic reaction but, from my own experience, expelling gas is good and it is nice afterwards to have no pressure from bloating and a flatter stomach.

Having worked on a switchboard for years, I was always stressed and had some painful bowel movements. I have done breath work occasionally so I started breathing and focusing my mind near the tailbone. At first it took 2 days before I went to the bathroom. then it got much faster as i would start breathing around that area of my body, when i wanted to go but couldn't. Now if I ever get constipation, I found a great a fiber pill I take and do my breathing trick and go almost immediately. It always works and the fiber pill just helps pull more out.

For anal fissures,
patients must eat some spinach with every meal including breakfast and some squeezed lemon juice with it. The greens will soften stools and prevent constipation, and the vitamin c will help heal. Hope this helps.

Years ago my doctor told me to use Anusol to relieve the extreme discomfort I was experiencing with my anal fissure. She offered no solution at all. It arose after I had a very difficult delivery of my son and burdened me for years. Fed up with the pain and the blood, I decided to change my diet. I eliminated red meat and deep fried foods. The fissure healed much to my extreme satisfaction and relief. When I attempted to eat red meat again the fissure re-opened and I could barely sit and I again bled when I had a bowel movement. I learned my lesson: never again to red meat. I have not had a steak, or a hamburger or a pork chop in over a decade, and I also avoid greasy food like chicken wings. I am almost a vegetarian meaning I skip eating meat entirely probably every other day, consume vegetables and fruit daily, and the only meat I eat is chicken, turkey and fish. No steak in the world is worth the pain of a fissure. To make a long story short: a change in diet was the answer.

Hi Jennie, I appreciate your article and have had the same issue occur. It is alarming when it happened and I read as much as I could and this was the start of may changes. I changed my diet immediately using tips and recipes from Dr. Kim; added his 100% organic greens and added a probiotic. I also made certain that my food in general was softer consistency for a while; steamed veggies; mashed up beans etc. It does work!

True. A change in diet is the answer to most modern ailments.

Hi all of you that suffer from this painful condition. I got an AF in october 2017 of reasons I don`t know. In the beginning the pain was worst when performing #2, but later on the pain developed after 2-3 hours because of spasms. I tried different kind of painkilling ointments + tried to keep the bowels smooth, but after suffering for 12 weeks I went to a specialist who prescribed Rectogesic. A combination of this ointment, plenty of water, Lactulose, almost only fish, fruit and vegetables + plenty of exercise (walking, running etc) seem to have cured me. It took about 3,5 weeks from the Rectogesic was introduced. I have been free of pain and spasms for 5 days now. Btw, it is important to keep the stools silky smooth, mine has been like a continous soft stool. And no pressing, use some standing position to easen the procedure.

Good luck to everybody (except my worst enemies),

best wishes from Kjetil, Norway

Anal fissure are aggravated by spasms of Anal sphincter which in turn cause pain, reduced blood supply to anal skin where anal fissures are there. To reduce spasms of Anal sphincter gradual anal dilation using Anal dilator starting from small size then gradually increasing sizes, available in surgical shops costing less than INR 200 ( less than $3) are very useful when combined with Sitz bath, Nifedipine ointment, High fiber diet, stool softener and emotional de-stressing. I am suffering from anal fissures for decades and whenever I resorted to anal dilator the fissure healed invariably but it relapse after weeks to month of stopping dilation as the Anal sphincter tone comes back. I tried to continue use of anal dilator even after healing but become lazy when pain subsides and default in treatment.

My tips..
Mine started several months ago with itchy irritation then developed into a tear. I have suffered pain and absolute agony. But I'm on the mend. Here's how.

I tried 2 ointments at first. First Rectogesic then a private prescription for Diltiazem. Neither really helped in my case.

So the consultant recommended Botox injection. After I had the injection it was agony the first day or so probably because I didn't keep to a soft diet. But I learnt my lesson! But I have to say it is now slowly healing. If I do the following things I get pain free bowel movements whilst the healing process is working. So read on folks.

Pray for healing. You can learn a lot about yourself when you suffer something like this. Little prayer = little power. More prayer = more power. Much prayer = much power!

Consultants advice
My consultant has advised me my stools should be like toothpaste in consistency whilst I'm healing. Which makes sense for this to heal.

Laxatives and stool softeners
I take 3 teaspoons of lactulose in the morning and 3 in the evening to soften the stools. I also take 3 sachets of Movicol in the day. These are the laxatives and stool softeners that work for me. I've tried others. But do your homework on laxatives as some shouldn't be used for prolonged periods.

Drink water and often. Then drink some more. A glass before bed time and a glass when you first wake up also help. Tip - always have a glass of water to hand. Try to minimise tea and coffee to 1 or 2 cups a day. I also drink Rubicon still Guava drink which seems to help.

I have fruit and water. Usually oranges and plumbs. Sometimes kiwi and strawberries or mango. All soft fruit. Often i have cereal to. Weetabix or Allbran. I usually mix the 2 and have soya milk on top. But not a massive portion.

Main meals
I have found that a bean salad with a large tomato and some parsley passes quite smoothly through my bowls so I would definitely recommend that. I usually put a salad cream or dressing on top to make it more tasty.

Chunky vegetable soup is also good.

Vegetable chop suey is nice just only eat the soft stuff.

I dont eat meat currently but might add a little tofu to the chop suey or salad.

I sometimes have a small slice of ujimatcha cake which is nice and light. Very tasty.

Oh and really chew your food........

Shower after EVERY bowel movement!

Bowel movement
Use sensitive non fragrance flushable toilet tissue wipes rather than toilet paper. This helps greatly!! Be very gentle but keep it clean. This really reduced my soreness on my skin. Regular toilet tissue was just to rough for me.
Always go to the toilet as soon as u feel the need. Dont wait. I find a cup of decaf kenco coffee with soya milk helps. Strange but true!

Dont strain on your bowel movements if at all possible. Sit and avoid squatting as some people do.

Saline solution
If you can then then once a day get someone to clean the area (after your bowel movement and shower) with saline solution. This has also helped me starting to heal. You are trying to stop the area getting infected also!

Barrier ointment
Use nappy rash cream as a barrier to protect the skin very recommended for when you walk. I use metanium (the yellow not the white). I apply this after my shower or after saline solution.

Walk often to get your blood circulating and fresh blood to the area to promote healing. But dont walk too much that it makes the area sweaty. Walks of about 20 mins duration work well for me.

Keep your underwear soft and clean!!! But be aware some softeners and detergents might irritate your skin so do your research.

Avoid sitting on hard surfaces.

This is working for me. You HAVE to have soft stools for it to start healing. I will keep a soft diet for some time after its healed. Maybe 3 months.

One thing to note if I deviate from any of the above then I might get pain so I'm sticking to this rigidly to allow it to heal.
Sometimes you may need a 2nd botox injection apparently. I had mine privately in London.

On the plus side with my diet it has improved my skin greatly.

God Bless folks!

Update to my previous message. I was torn when reexamined by the consultant. So went back to square one!
But... this time i have seen a very good consultant who referred me initially to a colorectal nurse. She has advised me to take 3 movicol at night before i go to bed. No lactulose. And when i wake i use a suppository to totally empty my bowels in the morning. Afterwards i have a hot sitz bath for 5 mins with epson salts. Then i squat and i clean on the inside with my finger up to 2 to 3cm (wearing surgical gloves). This is essential to aid healing. I then apply Diltiazem around anus and 2 to 3cms in. Diltiazem is applied 3 times a day. After 9 or so days i am still doing this and on her advice this is the treatment for now.I feel i AM healing and hopefully wont need another botox.

Still doing this and it is healing! Dont suffer. Take 3 movikol at night and a suppository in the morning. It IS working and virtually no pain whilst its healing.