An anal fissure is defined as a linear tear or ulcer of the anal mucosa. Patients typically describe a sharp pain ‘like passing broken glass’ on defaecation, followed by a burning pain in the anus lasting a few hours.1 Pain and bleeding during and after the passage of stool are the usual presenting features.2 Fissures are most common in young to middle-aged adults and are also commonly seen in pregnant and postpartum women. The lifetime incidence of anal fissure is around 11%.1 Here, we review the evidence on the efficacy and safety of non-surgical treatments for anal fissure.
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