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Anal Fissures

An anal fissure is a cut or tear occurring in the anus. Fissures are a common condition of the anus and anal canal and are responsible for 6-15% of the visits to colorectal surgeons. Anal fissures are caused by trauma to the anus and anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper, or in the toilet. Fissures cause severe periodic pain after defecation. Superficial or shallow anal fissures may self-heal within a couple of weeks. However, some anal fissures become chronic and deep and will not resolve on their own. The result is a non-healing ulcer, which may become infected by fecal bacteria. In adults, fissures may be caused by constipation, the passing of large, hard stools, or by prolonged diarrhea as well as anal sex. Anal fissures are also common in women after childbirth and persons with Crohn’s disease. About 4 million patients suffer from anal fissures in the US, and about 1 million doctor’s visits are caused by anal fissures. The only FDA approved solution is based on nitrates, but excellent results were observed for a treatment based on Calcium Channel Blockers.