Anal fissure

A longitudinal split or tear of the anoderm distal to the dentate line, typically in the posterior midline, causing severe anal pain and bright red rectal bleeding with defecation.

Causes

• Physical trauma: anal sphincter hypertonia and impaired local perfusion

  • Constipation

  • Chronic diarrhea

  • Child birth

  • Anal penetration

• IBD

• Infections: HIV, tuberculosis

• Anorectal cancer