Breakthrough treatment proves 90 success rate on painful anal fissures. 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 full thickness of the anal mucosa. File36258file36259for patient education resources, see the digestive disorders center, as well as anal absce. Anal fissure a tear in the lining of the anus, often caused by constipation. An acute anal fissure appears as a fresh laceration, while a chronic anal fissure has raised edges exposing the internal anal sphincter muscle fibres underneath. Chronic anal fissures are also often accompanied by an external skin tag (sentinel pile) at the distal end of the fissure and a hypertrophied anal papilla at the proximal end (difficult to see on physical examination) ( fig.). 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. 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. To see a diagram of a fissure, watch the video anal fissure--3d medical animation. World journal of gastrointestinal pharmacology and therapeutics 2. Anal fissure summary an anal fissure is a common, mostly benign, condition that can be acute or chronic. Breakthrough treatment proves 90 success rate on painful anal fissures.