CRS recommendation?

I have been dealing on and off with an anal fissure since the birth of my child last year. (I think I got it a couple months after the birth, from being dehydrated from breastfeeding.) I've tried all the creams, high fiber diet, tons of water . . . it goes away and comes back. I saw a doctor in SF who prescribed nitroglycerin cream, but I'd like to get another opinion. I see Dr. Bitar was recommended in the past, but he's retired. 

If anyone has any tips or good/bad experience with LIS, I would welcome those as well. 

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RE:
CRS recommendation? (May 7, 2019)

An anal fissure was most painful thing I’ve ever dealt with.. I could barely sit still due to pain by the time in finally had surgery and the moment I woke up it was over. The surgery is supposedly very easy and has great outcomes. The relief was immediate and no problems in the 4-5 years since. So sorry u have to deal w this! Good luck!

RE:
CRS recommendation? (May 7, 2019)

I’ve had this same issue and it’s the worst. I actually ended up getting a Botox injection after trying all the things you described above and it worked like magic. I’d find out if your doctor would be willing to try that. 

RE:
CRS recommendation? (May 7, 2019)

Could be hormonal! I had the very same issue after the birth of my son for about 2 years. I saw numerous GI doctors and Pelvic Floor Specialists, none of which helped. Finally I went to a Urogynocologist - as I assumed it must have something to with the birth. She told me right away that my estrogen levels had not yet returned to normal as I had just stopped breastfeeding about a month before the visit. Apparently, this is super common. If your fissure is on/near any tearing from childbirth that could be the issue as it has not been able to fully heal with low estrogen levels (I know sounds crazy when it’s been so long!) The doctor prescribed estrogen cream and told me to massage the scar tissue (which I didn’t even know I had!). It worked wonders for the couple months I did this. I had to stop the estrogen cream when I got pregnant and the problem has fully disappeared. That being said I am wholeheartedly convinced it had to do with hormones. Hope this helps!