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Anal fissure (AF) is a longitudinal tear or an ulcer in the anoderm of the anal canal distal to the dentate. It typically causes anal pain during defecation that may occur with or without rectal bleeding. AF does not occur spontaneously; the fissure is classified according to causative factors. Prolonged diarrhea or hard stool causing irritation and trauma to the anal canal are the primary and most common causes of AF. Secondary AF can occur in patients following an anal surgical procedure or with inflammatory bowel disease (e.g., Crohn’s disease, ulcerative colitis). AF affects all age groups with an equal incidence in both sexes.[1–3]

Anal fissure epidemiology and related diseases in children