digestive disorders
Anal Fissure
Introduction
An anal fissure is a tear or ulcer in the lining of the anus (the opening at the end of the digestive tract where stool leaves the body). Anal fissures may occur after passage of hard or large bowel movements. Symptoms include pain or bleeding during or after a bowel movement. The diagnosis is based on an examination of the anus. Treatment includes stool softeners, protective ointments, and sitz baths and sometimes botulinum toxin injection or a surgical procedure. Anal fissures may be caused by an injury from a hard or large bowel movement or from frequent loose bowel movements. Rarely, they may also be caused by penetration of the anus during anal sex. Fissures cause the anal sphincter (the muscular ring that keeps the anus closed) to go into spasm, which worsens pain and prevents healing. Anal fissures can occur in people of any age but are most common among infants. (See also Overview of the Anus and Rectum .) 