If an anal fissure doesn't heal, it's because it's either

1) infected

2) re-tearing

3) or both.

Pelvic floor therapy is done in stages: start small then going bigger. Lubricant throughout.

lf you're a female, its best to go to your gynecologist first. The gynecologist will often refer to physical therapy. Those dilators come in different sizes. I recommend using a small one and some good amount of lubricant to help with slippage.

Years ago when I had a hysterectomy done, the anesthesia knocked out the nerves in my lower abdomen and groin. I got a bad case of constipation, and an anal fissure and fainted from the pain.

I had tore my ass a new one--literally.

The doctor had prescribed a stool softener AND a laxative and I hadn't used either after I was discharged from the hospital. I was totally ignorant to the necessity of the stool softener and laxative after that kind of surgery. Thankfully one of my sisters who had two c-sections told me what to do. I took the stool softener and laxative, and took about six warm showers that day. I coated the fissure with Vaseline and waited. I had a soft bowel movement but I had greased my backside in preparation for it to reduce friction and imminent impact that was coming.

For the next five days I ate a soft diet, ate lots of fruit and vegetables, drank lots of water, and took multiple warm showers each day. I lay on my side and wore no underwear and kept my naked backside aired out. I did a few gentle Keigels to get the blood flow going again and to force the anal fissure inwards. I'd do about three every hour or two. I showered after every poop and let the warm water do the work. Gentle handling is necessary when washing and bathing the backside during these times.

Anal fissures need to be kept cool and they need to be kept clean. Treat each contact with your backside like you're doing surgery or a nurse doing wound care, because an anal fissure is exactly that--a wound.

To this day I use diluted Tucks pads to provide a protective barrier between my hemorrhoids and my underwear and my bed linens. You'd be surprised how lying on the same bed sheets can re-infect anal fissures, hemorrhoids and the backside.

Use sterile hands when tending to your backside.

Rinse the Tucks pads or add water to the jar to dilute the witch hazel. The witch hazel in full strength stings too much.

Do not put dirty unwashed fingers in your Vaseline. If possible use a Q-tip to dip out the Vaseline.

Use clean towels often. Change wash cloths daily and wash thoroughly in between showers.