Anal Fissure: A Frequent Reason of Anal Pain

Benign anorectal disorders are common and increasing in incidence. The decreasing intake in dietary fiber over the 20th century and into the 21st has contributed to a steady rise in preventable anorectal disorders. Anal fissure is a linear ulcer in the squamous epithelium of the anal canal located just distal to the dentate line. It is usually located in the posterior midline but occurs anteriorly in a fifth or more or patients. It typically causes pain during defaecation which may last for 12 h afterwards. is one of the most common anal diseases. It is characterized by anal pain on or after defecation and often by bright blood on the toilet paper. The pathogenesis of chronic anal fissure is not completely understood. Anal fissures presents mostly in children aged 6-24 months. The overall incidence in children is not well described. Most fissures heal spontaneously, but conservative management with ointment and fiber supplementation will relieve the pain and promote healing of those that do not. However, for a subgroup of patients with fissures refractory to medical therapy who are at risk of incontinence or are reluctant to undergo the gold standard surgical treatment of lateral internal sphincterotomy.