In normal practice, we often see patients asking: Doctor, is this a hemorrhoid or an anal fistula or an anal fissure? For these three most common benign anal diseases, many patients and friends are not clear. So I am going to give you a popularization with words + pictures to distinguish these three diseases. Anorectal disease is a common disease, the incidence is very high, according to statistics, the incidence of 59.1%, hemorrhoids accounted for 87.25% of them, that is, basically one in two people have hemorrhoids, so “ten men nine hemorrhoids”, “ten women ten hemorrhoids” this sentence The proverb, indeed, has some truth to it. So, what’s the deal with hemorrhoids? How can there be internal, external and mixed hemorrhoids? What do they look like when they flare up? The most important thing that you can do is to make sure that you have a good understanding of what you are doing. External hemorrhoids: Pathological dilatation or thrombosis of the subcutaneous venous plexus distal to the dentate line, forming external hemorrhoids. Mixed hemorrhoids: Internal hemorrhoids fuse with the corresponding external hemorrhoids through the rich anastomosing branches of the venous plexus to form mixed hemorrhoids Unlike cows, horses, pigs and sheep, which are quadrupeds, humans walk upright and have a low rectal canal, so the venous pressure inside is very high (this is also a “small flaw” in the evolutionary process). The fact that the hemorrhoids are a natural result of a long period of time is due to local congestion and venous reflux disorders. We all know some of the symptoms of hemorrhoids, such as blood in the stool, or “prolapse”. How are hemorrhoids treated? You can read my other article “Hemorrhoids can be treated with minimally invasive surgery”. Then we come to anal fissures, a word that makes you feel like your jugular is aching. Anal fissure is a mechanical fracture of the skin of the anal canal secondary to ulcers caused by dry and hard stools or repeated diarrhea, and patients are more afraid to defecate because of the pain, which makes the stool even more dry and hard, making it easier to fracture the anus when discharging, forming a vicious circle. A schematic diagram will help you understand. The most common symptoms of anal fissures: severe (some describe it as “cutting”) pain during stool and blood in the stool. Let’s take a look at what such a “vicious” fissure really looks like. It is not as scary as hemorrhoids, only the skin at the anal opening is cracked, but it is painful. The first episode or acute anal fissure can be treated with sitz bath and laxative, while chronic anal fissure can be treated with the aforementioned method plus anal dilation. In severe cases where the above conservative treatment does not work, surgical treatment can be used. Anal fistula is also a problem that people have heard of but are not quite sure about. It is actually a granulomatous tube that connects the anal canal or rectum to the (usually perianal) skin. In fact, depending on the height and number of internal openings, there are also distinctions such as high and low anal fistulas, but it is better to leave this professional judgment to the anorectologist. You can see several small pouches next to the anus, some are broken and some are not. This is actually the external opening of the anal fistula, so a common symptom is the flow of purulent and bloody discharge from the external opening. The majority of anal fistulas require surgery because they are difficult to heal on their own and are prone to recurring episodes of forming perirectal abscesses without treatment. The above three, should be the most common anal diseases. I hope that my explanations will give you the initial recognition ability. If you or someone around you has symptoms, you should come to the hospital in time to avoid delays.