It does appear that we have some of the same issues. I am going to order a tube of the ilex paste from Amazon and give it a shot. 

I use lidocaine with good results for numbing the pain. Unfortunately I have not heard of some of the others. Nifedipine does not seem to help me. When mine are really bad I tried anucort but suppositories are really tough when fissures  are really acting up. I do a lot of warm bath soaks. Maybe you can take a capsule probiotic in place of kefir. I am not fond of the sour taste either.  Also have you tried Imodium for the diarrhea or Metamucil? 

I used Calmospetine for some time but it is so stiff and sticky, it's hard to get off and it feels gunky. 

I use Benefiber and lomotil or Immodium. 

Meanwhile... The BLT cream has numbed the area around the fissure, but the fissure itself is inside, it is still excruciating! So hoping the Flexeril helps enough that I can sleep... Just hope it doesn't relax me into an accident!

Have you tried sits baths?  I use those and the ilex paste.  I just fill my bowl that comes in the sits bath with water as warm as I can stand it and sit there reading until the water cools.  Then an application of ilex paste keeps any further bowel movement from touching the area.  I use wipes and a bidet also. 

CLWAKLEY:

I do use sitz baths. They are effective for the moment and relax me right before bed. I do not have a bidet. And I haven't found any wipes that are flushable and safe for a septic tank. Have you?

The Flexeril at bedtime helps the spasms that are apparently causing the fissures for about the first 2 hours of bedtime. Then I'm right back up. Sunday night was heaven - slept in my adjustable bed in recliner position - got a full 5 hours without interruption! But last night back to up every hour again. One Percocet 5/325mg every 5-6 hours keeps the spasms down during the day if I don't get too rambunctious in my household duties. Have also gotten a pool and I "swim" and float around for an hour or so daily which helps me be extra tired at bedtime so I fall asleep easily. I'm doing some better. I just want to get off the meds that are addictive and establish a routine that will work for more than a few days!

Meanwhile... I found a way to make the Kefir tasty and get my fiber and proteins in too! I take about 1 cup Kefir smoothie (either plain or strawberry), 2 protein drink packets (1 vanilla, 1 wild berry or pineapple-orange), add about 1/2 to 1 cup ice cold water and a few frozen strawberries and blend it up! Yummy! A perfect breakfast!