I published a paper on this subject several years ago regarding post-operative complications of PPH. In order to address the heavy questions of patients, a short summary is made to facilitate patients’ understanding. This article focuses on painful discomfort. PPH has been claimed to be minimally invasive and painless since its emergence, but is it actually painful or not? Here is an explanation for you: Due to the special anatomical structure, the rectum and anus are rich in nerve distribution and there are great individual differences. Some patients who are sensitive to pain may feel much more pain after and during the procedure than they think. However, ordinary patients find that the PPH procedure is only a little painful and the bowel movement is very smooth, not at all as unpleasant as they think. If the pain is unexpectedly heavy, there must be a reason for it and measures need to be taken according to the reason. The best thing to do is to cooperate with the doctor’s arrangement and actively treat it. A. Postoperative anal pain Analysis of the causes: 1. We know that the nerve endings in the rectal mucosa area above the tooth line are mainly innervated by visceral nerves and are not sensitive to pain. However, the actual study of anatomy and physiology proves that there are some receptors sensitive to pain above the dentate line, so except for the operation of the surgery itself, individual patients may feel anal pain after the disappearance of anesthesia, especially within 24h after surgery, when the human body cannot tolerate various abnormal stimuli and the pain threshold is low. 2. The PPH anastomosis plane is too low. In particular, some patients have too much downward displacement of the anal canal or even ectropion, and the anastomosis plane must be close to the tooth line during surgery or the anal canal cannot be reset. 3, inflammation: inflammation of the anastomosis is also a common cause of pain. After our careful observation, the anastomotic nail at the anastomosis after PPH has three routes: part of it is buried in the tissue; another part is discharged with feces; and a small part may be embedded in the anastomosis and become a foreign body causing anastomitis, thus causing pain, swelling, discomfort, and even anastomotic stenosis. It is observed that the anastomosis position is too low may also cause swelling and pain in the anal canal. Treatment: 1) Anal pain relief; 2) Anti-infection; 3) Proctoscopic nail removal; 4) Very few patients complaining of anal pain after surgery, but no anastomosis, can be treated as “anal neurosis”, using induction, suggestion, acupuncture and anesthetic retention enema; 5) Chinese medicine treatment: empirical formula Xuan Shen Tang ( Bitter ginseng, Radix et Rhizoma Dioscorea, Yam, Rhizoma Atractylodis Macrocephalae, Rhizoma Atractylodis, Radix et Rhizoma Yu Hu, Radix et Rhizoma Glycyrrhizae, etc.). Postoperative anal swelling Different degrees of anal swelling are more common in patients after PPH surgery. It is manifested as an increase in the number of bowel movements, a small number of bowel movements each time, repeated bowel movements, the patient feels the discomfort of anal swelling, the urgency of the latter, which usually lasts for about two weeks. Analysis of causes: 1. low anastomosis plane during PPH surgery anastomosis. 2. inflammation: anastomosis inflammation is a common cause of pain, and is the main factor causing anal swelling. Treatment: the same as postoperative anal pain. Intraoperative abdominal pain can occur during PPH surgery, which is pulling-like pain, button pain or cramp-like pain, with pale face, cold sweat, or nausea and vomiting in severe cases. It is the peritoneal pulling reaction caused by the pulling of the rectal wall during the operation, and it is also related to the emotional tension of the patient. Causes: 1. the rectal mucosa is stretched during resection of the intestinal wall muscles. 2. more tissues are resected. 3. the purse-string suture is deeper and part of the intestinal wall muscles are directly removed. 4. insufficient anesthesia. 5. the visceral nerve tension is too high. Treatment: 1. preoperative 10 min intramuscular injection of Valium and 6542. intraoperative 654-2 drip and dulcolax, fenagan intramuscular injection according to the situation. 2. intraoperative 1% lidocaine rectal submucosal closed injection for those who use lumbar point anesthesia or local anesthesia for surgery.