This is a common condition which causes great misery. Typically the anus is split while passing a big hard lump of faeces often following a bout of constipation but there can be other causes. Defecation is extremely painful (described as passing glass) with some bleeding mainly on the tissue. The pain continues for several hours before gradually subsiding only to return at the next bowel movement. There are other conditions which mimic an anal fissure and hence expert medical opinion should always be sought. Initial treatment consists of simple measures such as analgesics, laxatives and creams such as Rectogesic or Diltiazem ointment for topical application. Sometimes surgical intervention is necessary if symptoms fail to respond to conservative treatment.