Inclusion Criteria:  For age between 18 and 65 years are the presence of acute anal fissure (with symptoms less than 6 weeks) following chronic diarrhea and subsequent fissure.  Exclusion Criteria:  Recurrent fissure with skin appendage. Long history of constipation. Use of immunosuppressive drugs or corticosteroids. Inflammatory bowel disease such as Crohn's disease and ulcerative colitis. Pregnancy. Grade 3 and 4 hemorrhoids. Neurological disease. Obsessive-compulsive disorder. Previous history of anal surgery Skin diseases such as eczema and psoriasis. Sexually transmitted infections, tuberculosis. Mucosal prolapse. Anal fistula and pelvic radiotherapy.