An anal fissure refers to a tear or break in the skin of the anal canal, often characterized by bright red anal bleeding on toilet paper or undergarments. While acute fissures can cause pain after defecation, chronic fissures may exhibit reduced pain intensity over time. Typically, anal fissures extend from the anal opening and are commonly found posteriorly in the midline due to the relatively unsupported nature and poor perfusion of the anal wall in that area. The depth of fissures may vary, ranging from superficial to reaching the underlying sphincter muscle. Without treatment, fissures can develop into skin tags known as sentinel piles, leading to discomfort and pain.