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We appreciate you taking the time to provide us with your comments. There will be new chapters monthly and of course, depending on your pledge, access to other chapters and books I have already published. If the patient is too apprehensive and in much discomfort, the examination should be aborted. With that I decided to take my online published chapters, bundle them into eBooks, and sell them to the masses. They may also ask about your toilet habits. Riding On the Fumes That Spark. Several anorectal disorders can present with severe anal pain; anal fissure is the most common cause of pain with or after defecation Table 1. Anterior fissures are seen more often in women. They may also ask about your toilet habits. If the patient tolerates the digital examination, then anoscopy can be performed. Evaluation The diagnosis of anal fissure is often made on the basis of the patient's medical history.

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