Anal fissures are tears of the anal mucosa. They can cause extreme pain (often up to 1–2 hours post-defaecation) and in many cases bleeding. Acute anal fissures are classified as lasting 6 weeks. Primary fissures have no clear underlying cause. This is in contrast to secondary fissures, which are thought to be caused by another principal condition.

If not treated effectively, anal fissures can lead to recurrence, infection, or abscesses. They can also lead to faecal impaction as patients avoid defaecation, not to mention the overall reduced quality of life.1 The lifetime incidence of anal fissures is estimated to be around 11%, with males and females equally at risk.2

Although many anal fissures are primary fissures without any underlying cause, secondary causes should also be explored. These can include: 

Examination is best performed in the lateral position, gently parting the buttocks …

Matthew Newman

Mhairi Collie

British Journal of General Practice

英国全科医学杂志是一本国际期刊，为全球家庭从业者和初级保健研究人员出版研究、社论、辩论和分析以及临床指导。BJGP 始于 1953 年，当时是“全科医师学院研究通讯”，以“ 1960年第一次出现全科医师学院学报。随着学院地位的变化，1967年创办了《皇家全科医师学院学报》。三位编辑后，1990年，标题改为“英国全科医学杂志”。该期刊通常被称为“BJGP”，是英国皇家全科医师学院的独立编辑出版物。

The British Journal of General Practice is an international journal that publishes research, editorials, debates, analyses, and clinical guidance for family practitioners and primary care researchers worldwide. It was established in 1953 as the 'College of General Practitioners Research Newsletter' and first appeared as the 'Journal of the College of General Practitioners' in 1960. Following changes in the college's status, it became the 'Journal of the Royal College of General Practitioners' in 1967. After three editors, the title was changed to the 'British Journal of General Practice' in 1990. The journal is commonly referred to as 'BJGP' and is an independent publication of the Royal College of General Practitioners.

《British Journal of General Practice》是一本国际期刊，专为全球的家庭医生和初级保健研究人员出版研究论文、社论、辩论、分析以及临床指导。该期刊始于1953年，当时名为“全科医师学院研究通讯”，并于1960年首次以“全科医师学院学报”出版。随着学院地位的变化，1967年创办了《皇家全科医师学院学报》。经过三位编辑的更替，1990年期刊名称改为“英国全科医学杂志”。该期刊通常被称为“BJGP”，是由英国皇家全科医师学院独立编辑和出版的。

Anal fissure: diagnosis, management, and referral in primary care

Anal fissures are tears of the anal mucosa that can cause extreme pain and in many cases bleeding and lead to faecal impaction as patients avoid defaecation, not to mention the overall reduced quality of life.

Category	Quartile
医学	2
医学, 初级卫生保健	1
医学, 医学内科	2

Anal fissure: diagnosis, management, and referral in primary care

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Journal Info

Category	Quartile
PRIMARY HEALTH CARE	1