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- Page navigation anchor for Anal fissureAnal fissureAs your review is under the heading "clinical intelligence" perhaps it is worth commenting on the more common route ofShow More
fissure referral to surgeons; more often than not a fissure hasbeen labelled a "painful pile" and treated with topical "pile cream" steroid, which you rightly did not include as a treatment of anal fissure (as it inhibits healing with prolonged use). Your piece iscertainly helpful for primary care as you importantly state that rectal examination is both painful and unnecessary to show a...Competing Interests: None declared.