Recurring anal fissure

An anal fissure is a common and often painful problem caused by a small tear or ulcer open sore in the lining of the anus back passage. This can cause bleeding, local itching and pain with a bowel movement, which can be severe. When someone has an anal fissure the first treatments can include a high-fibre diet, laxatives and applying anaesthetic ointments to the affected area. Anal fissures usually heal within a few weeks but those that have not healed after 4—6 weeks are called chronic fissures. If someone has a chronic fissure, it is thought that the reason it has not healed is that the ring muscle sphincter that goes around the anus back passage has become so tense that the flow of blood to the lining of the anus is reduced. That means that not enough oxygen carried by the blood gets to the fissure or tear.
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Chronic Anal Fissure.

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Complex Treatment of a Chronic Anal Fissure - Full Text View -

An anal fissure fissure-in-ano is a small, oval shaped tear in skin that lines the opening of the anus. Fissures typically cause severe pain and bleeding with bowel movements. Fissures are quite common in the general population, but are often confused with other causes of pain and bleeding, such as hemorrhoids. Anal fissures can occur at any age and have equal gender distribution. A small number of patients may actually have fissures in both the front and the back locations. Fissures located elsewhere off to the side should raise suspicion for other diseases see below and will need to be examined further. The typical symptoms of an anal fissure include pain and bleeding with bowel movements.
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Chronic anal fissure: 2% topical diltiazem hydrochloride

The anal canal is a short tube surrounded by muscle at the end of your rectum. The rectum is the bottom section of your colon large intestine. An anal fissure also called fissure-in-ano is a small rip or tear in the lining of the anal canal. Fissures are common, but are often confused with other anal conditions, such as hemorrhoids. Fissures are usually caused by trauma to the inner lining of the anus from a bowel movement or other stretching of the anal canal.
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Study record managers: refer to the Data Element Definitions if submitting registration or results information. Chronic anal fissure is a rupture of anal canal mucosa lasting for more than 2 months and resistant to non-surgical treatment. This condition is attended by severe pain syndrome during and after bowel movement defecation. This condition is most frequent in younger and working-age adults; therefore, the treatment issue is of particular relevance. The main cause of chronic anal fissure development is spasm of the internal sphincter.
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