A break in the skin lining the anal canal, usually causing pain during bowel movements and sometimes bleeding. Anal fissures occur as a consequence of constipation or sometimes of diarrhoea. The commonest site is midline posteriorly, followed by midline anteriorly. Medical treatment involves using stool softeners along with the application of soothing ointments and smooth muscle relaxants locally (e.g. 0.4% glyceryl trinitrate or 2% diltiazem). Surgical treatment includes the operation of lateral sphincterotomy (cutting the muscle of the anal sphincter) if the condition is severe and not responding to medical management.
Subjects: Medicine and Health.