• Severe cutting pains, patient prefers to remain constipated rather than going through the agony of pain.
• Bleeding stools are streaked with blood.
• Swelling is a large sentinel tag causes painful external swelling.
• Urinary symptoms are some patients may develop urinary retention, painful urination, increased frequency.
• Constipation is pain either initiated or aggrevated with passing stools so tendency to avoid going to stools so constipation.

Anal fissures can be caused by trauma to the anus and anal canal. The cause of the trauma can be one or more of the following:

• Chronic constipation
• Straining to have a bowel movement, especially if the stool is large, hard, and/or dry.
• Prolonged diarrhea.
• Anal stretching.
• Insertion of foreign objects into the anus.
• Longstanding poor bowel habits.
• Overly tight or spastic anal sphincter muscles (muscles that control the closing of the anus).
• Scarring in the anorectal area.
• Presence of an underlying medical problem: such as Crohn’s disease and ulcerative colitis, anal cancer, leukemia.
• Infectious diseases (such as tuberculosis); and sexually transmitted diseases (such as syphilis, gonorrhea, Chlamydia, chancroid, HIV).
• Decreased blood flow to the anorectal area.

• Pain during, and even hours after, a bowel movement.
• Constipation.
• Blood on the outside surface of the stool.
• Blood on toilet.
• A visible crack or tear in the anus or anal canal.
• Burning and itch that may be painful.
• Discomfort when urinating, frequent urination, or inability to urinate.

• Infancy: Many infants experience an anal fissure during their first year of life, although experts aren't sure of the reason.
• Aging: Older adults may develop an anal fissure partly because of slowed circulation, resulting in decreased blood flow to the rectal area.
• Constipation: Straining during bowel movements and passing hard stools increase the risk of tearing.
• Childbirth: Anal fissures are more common in women after they give birth.
• Crohn's disease: This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing

• Keep the anorectal area dry
• Wipe the area with soft materials, a moistened cloth, or cotton pad, avoid rough and scented toilet paper.
• Promptly treat all occurrences of constipation and diarrhea
• Avoid irritating the rectum

• Anal fissure that fails to heal. An anal fissure that doesn't heal can become chronic, meaning it lasts for more than six weeks.
• Anal fissure that recurs. If you've experienced anal fissure once, you have an increased risk of another anal fissure.
• A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter).
• This makes it more difficult for your anal fissure to heal. An unhealed fissure may trigger a cycle of discomfort that may require medications or surgery to reduce the pain and repair or remove the fissure.

• Ayurvedic Medical Treatment
• Kshar-Sutra Therapy
• Laser Treatment
• Fissurectomy and Lords Procedure