An anal fissure is a small, painful tear in the thin lining of the anal canal. It is usually caused by passing hard or large stools, long-lasting diarrhoea, or straining.

The anal lining has many nerve endings. Passing stool stretches the raw tear and sets off spasms of the internal sphincter muscle, causing burning pain that can last for hours.

An acute fissure is a fresh tear, present for less than 6 weeks, that often heals with medicine and diet. A chronic fissure lasts more than 6 weeks and develops raised edges, a skin tag and spasm, and usually needs a procedure.

Laser sphincterotomy releases the overactive sphincter spasm with controlled diode laser energy. This relieves pain and improves blood supply to the tear, so it can heal.

Most patients notice much less pain from their very next motion, because the muscle spasm is relieved during the procedure.

Yes. Piles mainly cause painless bleeding or swelling, while a fissure causes intense, burning pain during and after motions, with streaks of blood. An examination by Dr. Ranvijay Bharti confirms which it is.