Anal fissure is a common and debilitating condition which can cause pain, discomfort and disability far exceeding that might be expected from the size of the lesion. Pain, frequently described as “cutting” in nature, usually occurs during passage of stools and can continue even after defecation. This is usually accompanied by limited fresh per rectal bleeding seen on toilet paper.
Anal fissure, which represents an ulcer near the anal verge, is believed to be caused by the passage of hard stools causing tearing of the lining of the anus. Treatment involves relaxing the anal sphincter muscles and stools softeners. Traditionally, a minor anal surgery was the treatment of choice but non-invasive medical treatment has shown promising results and gained widespread acceptance.