 Hi, I am Dr. Shashidhar Guji Kerematta working as a yellow surgeon working in Manipal Hospital, Whitefield Today I want to talk to you about Fischer in Aeno This is nothing but a cut in the back passage Lot of the people experience this problem after passing a hard motion or straining to pass the motion Once the heart motion is expert, there will be a tiny cut either at the 6 o'clock or at all o'clock position That makes the patient to have a pain while passing the motion Most common presentation is the pain and also occasionally a tiny drop of blood on the streaks of blood Notice on the heart motion This condition is associated with people who consume less fibrous diet Those who have a plenty of fruits, vegetables and a plenty of water They are least likely to get into fissure in Aeno This condition can be treated conservatively or with a surgery Problem with treating with medication alone It means that patient has to change the lifestyle for permanently Especially drinking plenty of water, eating lot of fruits and vegetables Especially so after eating a non vegetarian meal Where the non vegetarian meal will have a low fiber content On that day you need to increase the fruit and vegetables a lot to be consumed more in quantity So that the next day the motion goes easily without becoming very hard The permanent cure for the fissure in Aeno is a surgery It is a tiny cut at 3 o'clock or 9 o'clock position Where we cut only half a centimeter of your internal sphincter fibers are cut Following the surgery, the pain what you use to suffer for many years will disappear And you will have a surgical pain for 3 to 5 days After the pain has subsided, most people feel not better There is less than 1% chance of infection in the cut bone Very tiny amount of blood loss probably around 10 to 30 ml of blood loss will happen in sphinctotomy And sphinctotomy done by a surgery has the most efficient way to treat the condition And it is a one day stay in the hospital and you will recover within a week to 10 days And you will get back to normalcy and it is a permanent cure for this condition If you are hesitant and delaying the surgery for pain and other reasons It will, patients will always end up with more problems And even more of them will come back after a failed conservative treatment for many years And the recurrent pain, that is the best solution is to have a surgery rather than wait and watch it Thank you