Here you are - I've not edited it. It refers to 'he' because it was written for a friend's friend.
The wonder drug is Diltiazem, and he must get some of this as soon as possible. I doubt if they have it out there (and it has to be made specially here in any case), but next time he or anyone else is home, that's what he needs to ask the doctor for.
In the meantime, here are the lifestyle things that can help (I'm not going to be euphemistic, because he needs help and I'm sure he's not going to be too precious about it!):
The main thing to remember is that anal fissures are a vicious circle (quite literally, I'm sure your friend would say!). It hurts and the body reacts in all sorts of automatic ways against this pain, usually by tensing the anus. HOWEVER, these automatic reactions hinder the healing process, both by restricting blood supply to the wound, and by creating more stress on the wound. What follows are therefore some tips to reduce pain and relax the anus, helping to break this vicious circle.
- Fibre AND water, at regular intervals throughout the day. Bear in mind that fibre is useless without water.
The key thing to remember is that a fissure is a wound, and the softer the poo, the less likely you are to open it further.
- Tension and clenching of the ass will make it more difficult for the wound to heal, as it decreases blood supply. However, the pain involved in having a fissure makes you much more likely to have a tense, clenchy ass (it's an automatic physical response to the pain). Your friend should try, insofar as possible, to be watchful to clenchy-ass and relax it. I once did a meditation class that advised us to imagine breathing through the anal mouth to relieve tension. Surprisingly effective.
- This tension and clenching also applies to actually going to the loo, and can really exacerbate the problem. Pooing is painful, so the bum clenches against the pain. However, this makes things worse as this means that the only bit of 'give' in the anus is the wound, which opens further as the poo passes through. (I told you I wasn't going to pull any punches!). This makes it worse, and so exacerbates the vicious circle is set up.
So your friend should also try the ass relaxation techniques while having a poo. Rather than pushing, try to 'breathe' the poo out, letting the anus relax a bit on the out-breath.
Sitting in a warm bath just before having a poo can really make a difference, helping to sooth and relax the bum.
It is tempting to avoid having a poo because of the pain. Try not to do this as it only makes it worse (your body absorbs water from the poo while it's sitting in the rectum, so the longer you leave it, the harder it gets. And as highlighted above, softness is all).
- Warm baths, generally, really do help sooth the pain.
- Avoid sitting down for long periods of time (just get up and take regular little walks). Also make sure that his chair (particularly the one in his office if that's where he spends most of his day) isn't too soft. Soft chairs cause the butt cheeks to spread, which can really pull at the wound.