Anal fissures are fissures that occur in the entirety of the skin of the anal canal and are most often caused by dry stools. It is commonly found in the front or back of the anus. Both men and women, young and old, can suffer from this disease. Anal fissure symptoms: The main symptoms are pain and bleeding. The pain is very characteristic, i.e., it starts with a sudden cut-like pain during defecation, then is relieved briefly due to the termination of defecation, followed by prolonged anal pain (due to spasm of the anal sphincter after stimulation). The pain of anal fissure occurs only during defecation and usually lasts for 20 to 30 minutes, or up to half a day or more in severe cases. Why does it hurt twice? The initial pain is caused by the expansion of the anus with feces, and the second pain is caused by the spasm of the anal sphincter produced by the first stimulation. Therefore, anal sphincter spasm is the main cause of anal fissure pain. Treatment of anal fissures: Early onset anal fissures can be completely cured by conservative treatment. For example, if a coarse fiber diet or laxatives are used to soften the stool, together with topical medication or herbal sitz baths, and if a specialist is asked to help change the medication at the same time, the recovery is faster and can usually be cured in a week. If anal fissures are not treated in a timely manner in the early stage, repeated anal canal ulcers with enlarged anal papillae sentinel hemorrhoids can occur. The anal sphincter spasm makes the fissure wound deeper and the wound ulcerates and erodes. Once an ulcer is formed, fecal matter remaining in the ulcer can easily become infected and form purulent sinus tracts. Anal fissures develop into anal ulcers, which can lead to anal stricture, and surgery can be expected to restore normal bowel function. Anal ulcers cannot be cured by life therapy of relieving constipation alone and must be treated surgically. The surgical method of anal fissure 1, anal dilatation: this surgical treatment of anal fissure under lumbar anesthesia, the patient takes a lithotomy or lateral position, local routine sterilization. The surgeon wears sterile gloves and applies lubricant to the index and middle fingers of both hands, inserts the index finger of the right hand into the anus first, and then inserts the index finger of the left hand, crosses the bowls of both hands, and expands the anal canal from the palm side of the index finger of both hands to the outside. Then gradually insert the second middle finger and continue to dilate the anal canal for 3 to 5 minutes to relax the sphincter and release the spasm. Be careful not to use violence or rapid dilatation of the anal canal to avoid tearing of the mucosa and skin during the operation. Patients should take a sitz bath with 1U5000 of potassium permanganate solution every day after the operation, and inject Jiuhua cream into the anus. 2.Anal fissure excision: This surgical treatment method for anal fissure is performed under local anesthesia, with the anal fissure fissure as the center, inside to the tooth line and outside to about 2cm outside the anal margin, to remove the anal fissure and its pathological tissues together and cut the pectineal band at the same time. Below the lower edge of the internal sphincter, stab with a curved hemostatic forceps, penetrate along the lateral side of its muscular layer, penetrate from the upper end of the internal sphincter, pull the internal sphincter out of the anus and cut from it, and the lower end needs to be cut with a knife as part of the subcutaneous layer of the external sphincter, so that the floor and edge of the wound are flat and open to ensure unobstructed drainage. Keep the wound open and change the medicine daily. 3, anal fissure lateral incision: lateral or truncated position, local disinfection and anesthesia, make a longitudinal incision at 1.5cm from the anal edge on the anal side, deep to the subcutaneous, expose the internal sphincter and pectineal band with hemostatic forceps, clip the lower edge of the sphincter with two vascular forceps and cut it under direct vision, the incision is usually not sutured, and drainage is induced by inlay pressure with red ointment gauze. The incision is usually closed without sutures, and the drainage is induced by inlaying red oil gauze. In conclusion, the surgery of anal fissure is to release the spasm of the internal anal sphincter to achieve the purpose of healing the ulcer of anal fissure.