Dr. Binaya Timilsina*, Dr. Prajwal Paudyal and Dr. Sarada Khadka


Introduction: Anal fissure is a split in anoderm. Most fissures occur in posterior midline and persist beyond 6 weeks. There is a deficit in clinicoepidemiological studies regarding this common clinical entity. So our study aims to identify lifestyle related risk factors causing chronic anal fissure. Materials and methods: A total of 112 patients attending surgery OPD, diagnosed as chronic anal fissure were included in the study. Results: There were 36 (32.1%) males and 76 (67.9%) female patients in this study. There were 81 (72%) patients whose fissure were located posteriorly and 29 (26%) patients anteriorly. Two (2%) patients have multiple fissures. Most common clinical symptom is painful defecation in all of the patients. Constipation was present in nearly two third of patients i.e. in 73 (65.18%) patients. Nearly half of the patients (51.8%) gave history of low fibre intake. Anal tone was increased in 61 (54.5%) patients and was normal in 51 (45.5%) patients. Hypertrophied anal papillae was present in 71(63.4%) patients. Conclusion: Our study revealed strong association of anal fissure with female sex, constipation and low fibre diet. Though constructive lifestyle recommendations could not be definitely advised by our study, a multi-institutional well constructed study is recommended to do so.

Keywords: Anal fissure, chronic anal fissure, painful defecation.

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