brother with anal fissure

Hi MH,

My brother, who is 43 has an anal fissure. It is an ongoing problem that comes and goes. It has ripped open and he is bleeding from it. I told him to put cold water on, and was going to give him some B&W ointment. Should I give him the one with cayenne or without? He says it is very painful, so much so that he can't sit, and doesn't want to go to the bathroom.

Yes, I know it's diet, he eats alot of red meat, not even organic, but he won't change much until he gets a really bad enough scare. he believes in science and drugs and is taking 6 different scripts because his insurance pays for it.

Thanks, MG