The most common causes of anal pain during stool are anal fissures and external hemorrhoids, the most common being anal fissures, which develop when dry stool cracks the skin of the anus, leading to spasm of the anal sphincter. The pain of anal fissures is usually a paroxysmal cutting pain after a bowel movement that lasts for several minutes or hours and is relieved only after the sphincter is fatigued. Newly developed anal fissures can be treated conservatively with pain-relieving herbal sitz baths and topical hemorrhoid cream to promote recovery. If the results are not good, surgical treatment is needed. The other is external hemorrhoids, which are edematous or thrombosed, and need to be relieved with a sitz bath of blood-boosting herbs and topical hemorrhoid cream.