Hi.
Thanks for your query.
Noted the history and understood the concerns.
The change in diet causing painful defecation with blood means that there is a
constipation which is instigating the problem of
fissure in ano.
I would advise you the following in such a condition:
Sitz bath three times a day, particularly before and after passing motion.
Regular use of stool softeners and laxatives to see what helps you.
Stop the foods and beverages that cause constipation and fissure.
Examination by a
general surgeon so that you get a proper evaluation.
Lord's anal dilatation or lateral cutaneous sphincterotomy helps a lot.
Control of
stress and
anxiety also assist in healing and avoidance of recurrence.
Continue this for a long time for the fissure to heal say at least 6 weeks.
Take probiotics, multivitamins.