An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper,sometimes in the toilet. if acute they may cause pain after defecation but with chronic fissures pain intnsity is often less. Anal fissures usually extend from the anal opening and are usually located posteriorly in the midline. Fissure depth may be superficial or sometimes down to the underlying sphincter muscle.
Most anal fissures are caused by stretching of the anal mucosa beyond its capability.
-Childbirth trauma in women.
-Poor toileting in young children
Non-Surgical treatments are recommended initially for acute anal fissures and chronic fissure may required surgical treatment such as: Lateral internal sphincterotomy or anal dilation.