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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The vascular pathogenesis of anal fissures. Warning You have reached the maximum number of saved studies They should titrate down or hold treatment if the child developed lose BM or diarrhea. A systematic review of the available randomized trials of these agents has shown that topical agents are marginally better than placebo [15]. The reason why anal fissure develops is still largely unclear, however the pathogenesis points to an initial anal trauma cause by the hard stool leading to anal sphincter hypertonia or spasm which cause local ischemia and non-healing ulcer.

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