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anal fissure; medical treatment;  

An anal fissure is a tear in the lining of the anal canal distal to the dentate line, which most co    more

An anal fissure is a tear in the lining of the anal canal distal to the dentate line, which most commonly occurs in the posterior midline. The majority of anal fissures are caused by local trauma to the anal canal, such as after passage of hard stool.The goals of therapy are to break the cycle of sphincter spasm and tearing of the anal mucosa, and to promote healing of the fissure. Medical therapy is successful in the majority of patients , with surgery being reserved for refractory cases. Medical therapy has traditionally consisted of three components: relaxation of the internal sphincter, institution and maintenance of atraumatic passage of stool, and pain relief    less