Patterns of Presentation and Prevalence of Fissure-in-Ano in a Tertiary Care Hospital: A Descriptive Study

Abstract

Background: Fissure-in-ano is a prevalent anorectal condition that mainly impacts young adults and is often linked to constipation and eating habits. The objective of this study was to evaluate the demographic characteristics, clinical symptoms, and typical anatomical location of fissure-in-ano in patients attending a tertiary care facility.

Methods: A cross-sectional descriptive study was carried out between May 2025 and July 2025 in the Department of General Surgery at Nepal Police Hospital in Kathmandu. A total of 300 patients aged 18 years and older, who presented with anorectal issues, were recruited via convenient sampling method. Information regarding demographics, dietary practices, history of constipation, clinical symptoms, and the location of the fissure was gathered and analyzed utilizing SPSS version 21.0.

Results: The largest group of patients (65.33%) fell within the age range of 18 to 40 years, with a slightly higher incidence among males (54.67%) than females (45.33%). A significant majority of patients (86%) adhered to a mixed dietary regimen, and more than half (58%) reported a history of constipation. The most frequently observed symptoms were painful defecation (84%), followed by rectal bleeding (54.33%), and constipation (52%). The fissures were mainly found at the posterior midline (92%). The patterns of clinical presentation were consistent across both genders. 

Conclusion: Fissure-in-ano typically affects younger adults and is closely associated with constipation and the location of fissures at the posterior midline. Early detection, modifications in lifestyle, and the regulation of bowel habits are essential for both prevention and management.