Fissure-in-ano is one kind of ailment that is embarrassing to talk about, given the nature of the symptoms and manifestations. However, it is one of the most prevalent conditions in the world, with millions of people suffering the agony of bad painful fissures. A fissure is a tear of the skin at the edge of the anus. It can cause pain, bleeding and/or itching. Causes: An anal fissure is usually caused by a hard and dry bowel movement, alongwith a tight anal musculature, which tears the anal lining, or diarrhoea and inflammation of the anorectal area. Trauma also can cause fissures. During childbirth, 11% of women develop anal fissures. Fissures can also be caused by digital insertion, foreign body insertion, or anal intercourse. A low-fibre diet may play a role in the development of fissures. Anal fissures affect people of all ages, particularly young and otherwise healthy people. They are equally common in men and women.