Fissure is a small tear or wound inside the anal canal. It is caused by hard stool trauma to the anal skin. After healing it leaves behind a small nodule and it is known as sentinel pile. It is associated with fissure. After every attack of fissure, it enlarges and becomes a cause of worry for patients. The pain is not felt in this mass but it is inside the anus in fissure. In general terms. it: is known as badi bawaseer. Acute fissure causes severe pain during act of defecation and chronic fissure causes less pain. There is narrowing of the anal lumen and it again precipitates the formation of fissure when stool is hard.
Acute fissure is managed by medicines and chronic fissure is managed by Ksharsutra ligation.