A tear in the mucosal lining of the anal canal - most commonly due to trauma from defecation

Acute - present for less than 6 weeks

Chronic - present for more than 6 weeks

  • Intense pain with potential bleeding or itching
  • Constipation and IBD risk factors
  • Most managed conservatively with analgesia, laxatives (stool softening) and fluids  - avoid opioids and NSAIDs.
  • Consider underlying cause in anterior fissures or recurrent disease
  • Surgical options in severe cases