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Self-help suggestions include switching to a high-fibre diet and drinking plenty of water. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice. She was discharged from surgical care at this point. A 25 year old woman presented to the Emergency Department complaining of severe perineal pain and bleeding after intercourse. Anal fissures may cause sharp pain and small amounts of bright red blood with bowel movements. At days follow up, the area had healed uneventfully and there was good continence, with a Cleveland Clinic Incontinence Score of 0. The patient consented to examination and repair under anaesthesia.