Anal Fissure is longitudinal tear in the lower end of anus. It is the most painful condition affecting the anal region. It commonly seen in young patients.

• Severe burning and pain during and after passing stool.
• severe constipation Drop of blood or streak of fresh blood during defecation.
• sentinel piles (Tag of skin at the outer end of anus).
• Itching.
• Hard stool (pellet like).

• Hard stool.
• surgical Procedure (Piles surgery).
• spincter hypertonia (spasm of anus)
• Repeated child birth.
• Excessive use of ointments.
• Excessive use of laxatives.

• Per rectal examination with lignocaine jelly application.
• Proctoscopy is contraindicated because the condition is very painful. (If require can be done under general anasthesia).

• Anemia.
• Pain.
• Infection.
• Fistula