Now it’s the ninth winter, people outdoor activities reduce, in order to drive cold, some people like to eat spicy hot pot, barbecue and other food, these factors, invariably trigger and aggravate the occurrence of anorectal diseases, including anal fissures. In the clinic, we find that the number of patients coming to the hospital for anal fissures in winter is significantly higher than in summer. So, what is anal fissure? In the clinic, we often hear patients describe that they are afraid to have a bowel movement for a period of time, and when they have a bowel movement, their anus feels like a fissure with pain and discomfort. Patients ask, “What is this disease? Other patients ask, “Is it a cracked anus? After listening to the patient’s description, we felt that these conditions were consistent with the clinical manifestations of anal fissures. After examining the patient locally, we told the patient that he indeed had an anal fissure. Academically speaking, anal fissures are non-specific radiating longitudinal fissures or ulcers on the skin of the anal canal below the dentate line. It is usually poke-shaped or oval, about 0.5 to 1.0 cm long, and the location of the fissure is not deep, just inside the anus near the anal opening. Anal fissure is a common anorectal disease with a high incidence, just below hemorrhoids, which ranks second in the incidence of anorectal diseases, accounting for 15% to 22% of anorectal diseases. The incidence is mainly in young adults, and more women than men. More than 75% of anal fissures are located in the posterior median position of the anal canal, followed by the anterior median position, and women often have both anterior and posterior positions at the same time. In Chinese medicine, anal fissures are called “fissured hemorrhoids” and “hooked hemorrhoids”. How do I know I have an anal fissure? What are the main symptoms of anal fissure? 1, anal pain Typical anal pain caused by anal fissures is characterized by periodic pain. The specific performance is anal pain during defecation, paroxysmal cutting-like pain or burning pain, the pain is reduced or disappeared within a few minutes to more than ten minutes after defecation, called the pain interval. Subsequently, the pain is severe due to persistent spasm of the sphincter muscle, which often lasts for several hours before it can be gradually relieved. In severe cases, coughing and sneezing can cause pain that radiates to the pelvis and lower extremities. The pain is not relieved until the anal sphincter gradually relaxes and contracts weakly. It is a cyclical vicious cycle of “pain – relief – severe pain – stop”, making people suffer a lot. 2. Bleeding during stool The blood is bright red, usually dripping, but the amount is small, or only attached to the surface of the stool, or sometimes only the toilet paper is blood-stained. It should be noted that the characteristics of anal fissure blood in stool are: bleeding during stool, bright red blood, accompanied by anal pain, this characteristic is different from internal hemorrhoid bleeding. Constipation Many patients, unable to tolerate the pain caused by anal fissures, tend to habitually hold their stools and urine, which over time makes the stool dry and difficult to discharge, and the stool accumulates in the intestines for a long time, resulting in constipation. Constipation makes anal fissures more and more serious, and the pain becomes more and more intense, making it difficult for the fissures to heal on their own. These three points are the main symptoms of anal fissures. If you have these conditions, you should go to the hospital and ask a specialist to see if it is an anal fissure. Because it is not enough to diagnose anal fissures with just these symptoms. It is very important to conduct a local examination on top of these symptoms, as the local examination and symptomatic manifestations are all compatible with anal fissure in order to make the diagnosis of anal fissure.