It is a painful linear slit (ulcer) of the anal canal that extends from the mucosa to the muscle fibers of the internal sphincter. The passage of hard stools with the subsequent spasm of the internal sphincter create the tear at the lining of the anal canal. Other causes that lead to anal fissures are childbirth, injuries, Crohn’s disease. The most common symptom is a sharp pain or burning sensation when passing a stool that lasts for hours afterwards. It may be accompanied by bleeding, mucus secretion and itchiness. This can lead the patient to avoid the toilet.
Anal fissures often heal within a few weeks by taking fiber supplements, sitz baths and local ointments (nitroglycerin) that tend to relax the sphincter. When these measures fail Surgery is recommended. It involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing by restoring normal blood flow.