Anal fissures are one of the most common causes of anorectal pain. Anal fissures are tears in the lining of the distal anal canal, usually along the middle back. The exact causes of anal fissures remain unknown. They are often associated with trauma, e.g., passage of a hard stool, but can also occur during bouts of diarrhea, childbirth, or ulceration of a hemorrhoid. The most common symptom of an anal fissure is pain at bowel movement, which can be quite severe and last for some time. Many acute anal fissures will heal within three weeks using treatments such as sitz baths, stool softeners, anal fissure ointment and analgesics (pain medication). However, it is common that anal tears do not heal as a result of such treatments, and in such cases it is possible that chronic anal fissures or anal ulcers are produced.