Anal Fissure 

Anal fissure is a tear in the inside lining of the wall of the anus. It is caused by the passage of very hard stools and strong pressing and a predisposition for this condition. The symptoms are clear and consist of very severe pain as the stool passes as well as itching, burning, bleeding and wet discharge from the anus. The diagnosis is based on digital rectal examination and simple stretching of the skin of the anus.

Therapy
Anal fissures are usually treated by nitroglycerin ointment which has to be applied to the anus for 2 weeks. A high-fiber diet is also recommended to maintain softness in the stools.

If this therapy is not successful, botulinum toxin may be injected into the anal sphincter.

If this therapy fails as well, surgical correction consists of a small operation to cut a portion of the internal anal sphincter muscle with excision of the fissure.