Anal Fissure

Anal fissure is a small break or tear in the skin of the anal canal , which typically runs from below the dentate line to the anal verge and is usually situated in the posterior midline( Zaghiyan KN et al 2011 , Madalinski MH et al 2011 )

Most common cause of severe anal pain Mostly affect young people 2nd and 4th decades of life Most papers report an equal distribution between men and women Lifetime risk has been reported between7.8 % to 11.1 % ieAnal Fissure ( AF ) is a common problem but it is now very well known exactly how widespread this problem is Studies have shown association with pregnancy- in a prospective study of 165 women , 2 had AF before delivery but 25 % ( 15 ) had AF afterwards with half occurring more than 2 weeks after delivery ( Abramowitz L et al 2002 ) It can cause significant morbidity in otherwise young and healthy population

Etiology remains unclear Trauma from passing a large bowel / hard stool or diarrhoe can also cause initial trauma Increased anal sphincter tone - possible play a role in persistence Fewer anal tone relaxations have been shown in...