A fissure is a tear in the anal canal. This often occurs following a hard motion. It does not heal and forms a small ulcer.
A fissure is usually painful, causing a sharp pain at the time of defecation, and often lasting for some time after. Fissures often cause bleeding on wiping or on the stool. They may heal themselves or require further management.
Treatment aims to heal the fissure. Initial management includes ointments to help relax the muscles of the anal canal and increase the blood supply to the tissue for healing to occur. Stool softeners are also useful to decrease pain and decrease the tearing on defecation.
Botox may be used if ointments fail. Sometimes a lateral sphincterotomy (or small cut to the anal muscle) is carried out under anaesthetic if these measures fail.