An Anal fissure is a longitudinal split in the mucous membrane of the anal canal.
Severe pain in the region of the anus during and after a bowel movement is the dominant symptom, as well as the occasional presence of small amounts of bright red blood. Very often, anal fissures are associated with hemorrhoids and hypertrophic papillomas that the patient can feel in the area of the anus.
Clinical examination with endoscopic examination of the anal canal (anoscopy) is sufficient for diagnosis.
Since anal fissures in their clinical course can be acute or chronic, the treatment can be conservative or surgical.
An attack of an acute anal fissure is always treated conservatively at first with the help of medications and proper nutrition. If conservative treatment does not lead to a cure within four to six weeks, fissures can be considered chronic.
Chronic anal fissures can only be treated by surgery and the aim of the operation is to reduce the spasm of the anal sphincter resulting in reduction of intra-anal pressure, which is considered a major cause of anal fissures.