Anal fissure is a split in the lining of the anus which leads to marked pain when passing motion. This is often associated with bright red rectal bleeding. Simple measures such as increasing fibre and water intake, and ointments can be helpful. Usually a colonoscopy is necessary to identify other possible causes of these symptoms. If there are persistent anal fissure symptoms, Vanessa can arrange further treatment with Botox injection to the anal muscle which is in spasm in patients with anal fissure. Botox is approximately 80% effective for anal fissure and minimises the risk of long term continence issues associated with surgical treatment.