When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance. Anal fissure causes severe pain on defecation, often described as "like passing broken glass.
A small amount of fresh red blood is often passed on the stool and is also seen when wiping. On examination of the anus, there is often marked spasm of the sphincter muscles, with significant tenderness often precluding digital examination.
Initial treatment should include either topical nitroglycerin or diltiazem, along with a program of supportive care. Resistant or chronic fissures may benefit from injection with onabotulinumtoxinA, and most cases can be cured by surgical sphincterotomy or anal advancement flap. Anal fissure is a split in the skin of the distal anal canal characterized by pain on defecation and rectal bleeding. It is a common condition in young to middle-aged adults and may occur in 1 in people. Current concepts in anal fissures.
World J Surgery. The pain is described as severe often described as "like passing broken glass" and has a serious negative effect on quality of life. Aetiology and treatment of anal fissure. Br J Surg. A review of chronic anal fissure management. Tech Coloproctol.
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Chronic anal fissure in adults. JRTM declares that he has no competing interests. JS and JL are authors of a number of references cited in this topic. Anal tears. Use of this content is subject to our disclaimer.
