Talk to Gastroenterologist on Anal Fissure + Hemorrhoid

i have had constipation 3 years ago and since then have one hemorrhoid and one anal fissure. hemorrhoid is always seen outside and is painless but anal fissure has started giving me pain since 2-3 months however it never bleeds.

i have used GTN, diltiazem + psyllium husk 3 times + cremaffin syrup symptoms improve after some days slight hard stool or diarrhea makes it worst again.

is some doctor or surgeon do Botulinum toxin injection (botox) treatment for anal fissure in Pakistan? before going for surgery i want to try botox injection treatment. please tell me which doctor doing it in Karachi. thanks

or tell me some good stool softener because i heal and then little hard stool makes it worst.