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an anal fissure is a superficial linear tear in the anoderm that is distal to the dentate line. Anal fissures are often associated with the passage of hard stools or anal trauma, but the exact etiology often remains unclear. If your anal fissure is particularly severe or doesnt respond to treatment after 8 weeks, you may have to be referred to a colorectal surgeon, a doctor who specialises in conditions that affect the rectum and anus, for specialist treatment. Sitz baths, or hip baths, can promote healing of an anal fissure. By soaking the rectal area in a tub of warm water -- two or three times a day for 10 to 15 minutes -- you can clean the anus. Anal fissure is one of the most common benign anorectal conditions. Trauma to the anoderm with the passage of a hard stool is thought to be a common initiating factor. Persistence of a fissure is typically associated with anal spasm or high anal pressure. These may include a medicated cream (to help heal the fissure), a topical muscle relaxant (to relax the anal muscles), an anesthetic ointment (to reduce pain, if pain interferes with having a bowel movement), or nitroglycerin or calcium channel blocker ointments (to relax the anal muscles and increase blood flow to the region, promoting healing). anal advancement flap versus lateral internal sphincterotomy for chronic anal fissure- a systematic review and meta-analysis. These include an anal fissure, a tear in the anal canal, that becomes.