Clinicopathological Profile of Anal Fissures in a Tertiary Care Setting: A Retrospective Analysis

Background: The epidemiology and contemporary treatment of anal fissures (AF) are underreported in the literature. To address this deficiency, this investigation examined the incidence, comorbidity profiles, and treatment patterns of anal fissures within a hospital-based population. Methods: This retrospective analysis examined all adult patients (≥20 years) diagnosed with anal fissures (AF) at a tertiary care teaching hospital from 2022 to 2024. Case ascertainment was performed using hospital utilization records, encompassing outpatient visits, inpatient admissions, and surgical interventions. Comorbidity profiles were evaluated by comparing cases to age- and gender-matched controls. Results: This retrospective analysis of 350 anal fissure (AF) cases indicated a female predominance (60%, n=210) over males (40%, n=140). The age-specific incidence of AF varied significantly by sex, with peak incidence occurring in females aged 31-50 years and males aged 51-70 years. Furthermore, the study identified statistically significant associations between AF and several comorbidities, including chronic constipation, hypothyroidism, obesity, and solid tumors without metastasis, with elevated prevalence rates observed in the AF cohort. Conclusions: Anal fissure is a clinically significant condition with a heterogeneous incidence across age and sex groups. Common comorbid conditions include constipation, obesity, and hypothyroidism. Initial management typically involves topical medications, though prescription adherence is often poor. Surgical interventions, encompassing botulinum toxin injection and lateral internal sphincterotomy, are employed less frequently.