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Sunday 5 July 2026

Peer Reviewed

Gastroenterology clinic

What to do for a patient with an fissure in ano

Peter J Stewart

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Abstract

An anal fissure is a common anorectal problem that can occur at any age. Here, Dr Peter Stewart discusses the management of this painful condition.

Key Points

Remember

Think of a fissure in ano in a patient presenting with moderate to severe anal pain of sudden onset occurring with and immediately after defaecation, often in association with rectal bleeding.
An anal fissure is a very common anorectal condition, and may be acute or chronic.
A fissure is usually caused by the passage of a hard motion which causes a tear in the delicate, pain sensitive anal mucosa. The exposed internal sphincter fibres spasm, causing pain and local ischaemia that delay healing.