Anal Fissure

Anal fissure is a tear in the mucosa of the anal canal caused by the passage of a large constipated stool. The pain may be severe and cause spasm of the internal sphincter, making defaecation difficult and increasing constipation, thereby exacerbating the situation. Some cases may be managed by local anaesthetic creams and stool softeners, but chronic cases may need creams containing nitrites which relax smooth muscle, or surgery to divide some of the fibres of the internal sphincter - a procedure which carries the risk of future incontinence, particularly of flatus.
 
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