Fissure-In-ANO

Abstract

This chapter provides a summary of the aetiology, diagnosis, investigation and man- agement of anal fissure. It gives an overview of clinical anatomy and pathophysiology related to anal fissure. Focusing on anal sphincter hypertonia as the key factor for anal fissure progression, the chapter draws attention to perpetuating factors that contribute to a vicious cycle of fissure non-healing and addresses management options for these factors. This chapter also looks at the way how different treatment options for anal fis sure emerged over time and uses evidence-based medicine to compare these options. “ Fissure-in-ANO” concludes with summarising the treatment options and suggesting an algorithm for management of acute and chronic anal fissures.