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Longitudinal tear in the lower end of anal canal results in Fissure in Ano. It occurs most commonly in the midline posteriorly, the least protected part of the Anal canal. It is caused at the time of passing hard stools. It may be extremely painful and generally happens in the sensitive part of anal canal. Anal fissure starts at the opening of anus and in a minimum time it spreads in the anal canal.  About 80% of general population around the world have some kind of anal fissures. Therefore, it is considered as a most common problem in Male & Female.

Pathology of Pain:Fissure starts proximally at the dentate line. So,whole of the anal fissure lies in the sensitive skin of the anal canal and that’s why pain is the most prominent symptoms.

Symptoms:Severe pain with pricking and burning sensation after defecation, occasional bleeding from rectum, itching in the anal region etc. are some of the major symptoms of anal fissure. This disease can recur again after certain time interval. Recurrence of anal fissure results in chronicity of disease and a skin tag develops either on 6 O’ Clock or 12 O’ clock as a result. This is a small skin tag hanging outside the anal orifice. It is usually seen in the patients of chronic anal fissure. Usually this tag is painless but when inflamed; it may have swelling and severe pain.

Treatments: Lateral Sphincterotomy or anal dilation is the surgery recommended by the surgeons for treating anal fissure. Recurrence and incontinence of stools are the most common post-operative complications.  Whereas in Ayurveda; Anal fissures are treated without surgery by Pratisaraniya Kshara therapy after anal dilatation. Pratisaraniya kshara is repeatedly apply at weekly interval. Pratisaraniya kshara helps in complete healing of anal fissure. Anal fissure may get healed in 3 – 4 weekly therapies depending on chronicity of fissure. 

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