The main causes of anal fissure formation may be related to the following factors: long-term constipation and hard stools, which cause mechanical damage during defecation as the direct cause for most anal fissures. It is also related to anatomical defects. Due to the superficial layer of the external sphincter forming a weak area at the back of the anal canal, dry stools exert the greatest pressure on the weak area at the back of the anus, making it prone to tearing injuries. Additionally, infection of the anal sinuses can lead to inflammation of the anal canal, and spasms of the sphincter losing its soft characteristics is also a reason for the formation of anal fissures. Furthermore, hard and dry fecal masses passing through the anal canal can easily cause tearing injuries, possibly due to the smaller size of the patient's anus.