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Anal fissures

​Anal fissures are a common cause of perianal pain that has been a source of frustration to man and their physicians for thousands of years. The symptoms of pain and bleeding on defecation are very often erroneously attributed to hemorrhoidal disease, even by physicians themselves. It represents about 10 to 15% of referrals to any colorectal practice. This issue of S-files aims to describe the fundamental pathophysiology of anal fissures, the investigational process to adopt when managing a patient with suspected fissures and the evidence-based efficacy of treatment modalities that are currently available.