Would taking potassium spearing diuretic such as spironolactone in addition to hctz (hydrochlorothiazide) aggravate or slow the healing of anal fissure?

CAUSE CONSTIPATION: Diuretics has no effect what so ever on anal fissure better or worst saying that if the diuretics will end up causing dehydration bad enough to cause constipation then yes that could cause the anal fissure to be worst saying that we do treat the anal fissure with vasodilaters a medication that is used to treat hypertension and that have been very helpful.

Not likely: There has been a suggestion of a handful of reports to the FDA saying that spironolactone is associated with anal fissures. However, the reports are both rare and not an indication that the drug causes fissures. (For example, it may be that spironolactone or hydrochlorothiazide aggravate existing anal fissures by causing other side effects like diarrhea or constipation.)