Anal fissures can be very painful and if they don't heal within six months you may need to talk to your doctor about it and best options. We tried lots of different things - Miralax, Collace, etc which didn't necessarily work for me - everyone's colon is different so you need to have a GI doctor or primary who can understand how your colon works and your needs. Adding Supplemental Fiber is the best thing that works for me - I would look up the best fiber supplements to take. I had to have surgery but am post anal fissure repair and it hasn't come back. My local surgeon did it but I consulted with the colon rectal surgeon at Mayo first and he agreed we could do it locally. Also consider doing pelvic floor therapy or at least talking to your primary to see if there is any value in that. I also felt like the sitz bath helped to relieve it some. Have you tried a sitz bath - the one I used was actually able to pump warm water so it kept it warm and you could do it on the toilet so you didn't have to get in the bath everytime. I will have to look it up and see if I can find more info on it.