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An anal fissure is a linear tear in the skin of the distal anal canal below the dentate line. It is a common condition affecting all age groups but particularly common in young adults men and women are equally affected. The classical symptoms are of anal pain during or after defaecation and the passage of bright red blood per anus. the surgery, called a lateral internal sphincterotomy (lis), involves making a small cut in the anal sphincter muscle. 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. an anal fissure is a tear of the squamous epithelium that usually extends from the dentate line to the anal verge. In 90 of cases, the fissure manifests as a painful linear ulcer lying in the posterior midline of the anal canal. If your anal fissure doesnt heal, or comes back after a sphincterotomy, your surgeon may suggest you have some tests to check whether the surgery went to plan. These may include an ultrasound scan of your anus and tests to see how well your sphincter muscle is working. anal fissures, or tears in the mucous membranes supporting the anus, are very common, painful problems. Most fissures are small and temporary, generally responding well to home remedies and medications. A fissure can become a chronic nuisance for some people, however, and surgery may be recommended as a permanent cure. surgical options for treating anal fissures the pain from an anal fissure can be intense enough to cause sufferers to reduce their activity level on a daily basis. In the most severe cases, it can cause discomfort for several hours after using the bathroom, and greatly reduce quality of life. The goal of surgery is to help the anal sphincter muscle relax which reduces pain and spasms, allowing the fissure to heal. Surgical options include botulinum toxin (botox) injection into the anal sphincter or surgical division of an inner part of the anal sphincter (lateral internal sphincterotomy). in this patient education video for colorectal surgical associates in houston, texas, learn more about an anal fissure.