It is crack in the skin-lined part of Anal canal.Usually seen in young or middle aged adults & common in both sexes.

Causes:
1) Constipation, Injury to Anus during passage of large hard stools. It is seen in Proctocolitis, Crohn's Disease very rarely.patients presented in acute stage as severe anal pain associated with defecation In chronic cases which is characterized by hypertrophied anal papilla internally and sentinel tag externally. Patient may also complain of itching, discharge from ulcer.
2) Repeated passage of Diarrhoea, tuberculosis.

Treatment:
1) Intake of High fibre diet,green leafy veg, fruits, salads will help to prevent this complaint.
2)Stool softener should be given to avoid constipation.
3)Application of Lubricant & Local Analgesics ointments, sitting in hot water gives relief from the symptoms.
If above treatment fails to give relief then one should consider for following modality of treatment.

Surgical :
1) Chemical sphincterotomy: Using glycerine trinitrate 0.2% Diltiazem 2% apply twice daily.
2) Sphincterotomy:
    a) Open : Incision of the overlying anoderm & direct exposure of sphincter (muscular part)
    b)Closed:Fissurectomy with division of the sphincter with repair.

Above mentioned surgery can be easily done as day care surgery in Abhishek Day Care Centre, patient will be discharged on the same day. After surgery patient is advised to take pain killers, stool softners, antibiotics, ointment, sitz bath ( sitting in luke warm water).