Anal Fissures :
An anal fissure is a tear or crack in the inner lining of the anus. Most of these fissures occur due to passing hard or large stools, due to constipation and straining over bowel movements and a few due to trauma to the anal region. The causes of anal fissure are chronic diarrhea, inflammatory bowel diseases, and childbirth. It is typically piercing and, in this patient, occurs with or following a stool, anywhere from minutes to hours. Other signs besides bright red blood on the toilet paper or in the stool may include irritation or itching around the anus. This is usually managed with relief of symptoms and healing of the tear. It could be achieved by increasing the intake of dietary fiber and water, stool softeners, and preventing straining to pass stools. Over the counter creams or ointments that contain hydrocortisone can be applied along with sitz baths-sitting in a bath of warm water. The General surgeon might provide medicated creams that relax the anal muscles or injections of botulinum toxin in some cases. Surgery is rarely required, it is only carried out in case the treatment fails for the chronic or severe forms of it.