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an anal fissure (see the images below) is a painful linear tear or crack in the distal anal canal, which, in the short term, usually involves only the epithelium and, in the long term, involves the. Anal fissure summary an anal fissure is a common, mostly benign, condition that can be acute or chronic. An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet paper and undergarments, or sometimes in the toilet. If acute they are painful after defecation, but with chronic fissures, pain intensity often reduces. Anal fissures usually extend from the anal opening and are usually located posteriorly in the midline. Anal fissure (diagnosis (investigations (bloods fbc, crp, ue, lft (nil) anal fissure (diagnosis, complications, management, epidemiology, pathophysiology, aetiology, clinical presentation, prognosis, differentials, definition a tear or ulcer in the lining of the anal canal, immediately within the anal margin). World journal of gastrointestinal pharmacology and therapeutics 2. chronic anal fissure resistant to conservative treatment and may require surgical management epidemiology. Most commonly affects infants and young middle aged individuals equally prevalent in males and females diagrams tables. The anatomical anal canal extends from the perineal skin to the linea dentata. Surgically, the anal canal extends from the perineal skin to the anorectal ring. This is the circular upper border of the puborectal muscle which is digitally palpable upon rectal examination. The anorectal ring lies approximately 1-1,5 cm above the linea dentata. an anal fissure is a small tear or crack in the lining of the anus. If you experience severe pain or bright red bleeding during or after bowel movements, you may have an anal fissure.