Anal fissures are fissures in the skin of the anal canal. Depending on the duration of the disease and the condition of the fissure, there are two types of fissures: acute and old. Why do anal fissures occur? The classic text of Chinese medicine, “The Golden Book of Medicine”, says: “When the anus is surrounded by folds and ruptures and the stool is knotted, the fire is also dry.” Therefore, yin deficiency and lack of fluid, or heat knot intestinal dryness, and cause constipation, defecation nuisance, so that the anal skin fracture, moisture and heat contain the obstruction, infected with poison and the development of the disease. Modern medicine believes that the cause of anal fissures is initially caused by dry and hard stools that tear the skin of the anal canal, resulting in anal pain and blood in the stool, which makes the patient fearful of defecation. If the correct treatment is not given in time, dry and hard stools and anal pain and bleeding will repeatedly affect each other in a vicious circle, and acute anal fissures will gradually turn into old anal fissures. So, the question arises: What is acute anal fissure? What is an old fissure? What is the difference in treatment? Acute anal fissures are simple tears in the skin of the anal canal, and most of them can heal on their own by improving the stool properties and using topical anal medication. However, acute anal fissures turn into old anal fissures after the symptoms of anal canal skin tearing for more than 8-12 weeks. At this point, the fissure manifests as a full longitudinal splitting of the anal canal skin and the formation of ischemic ulcers, with chronic inflammation and fibrosis, or with redundant skin at the anal margin and enlarged anal papillae, and in some patients the internal anal sphincter is exposed in the center of the fissure. As a result, there are typical symptoms: blood in the stool, constipation, and periodic anal pain. The so-called anal cyclic pain refers to the burning or cutting pain in the anus immediately during defecation due to the stimulation of the nerve endings in the anal fissure, which is temporarily relieved for a few minutes after defecation, followed by severe pain that lasts for several hours due to the contraction and spasm of the internal anal sphincter. In terms of treatment, early treatment is advocated once it occurs. For acute anal fissures, more than half of the patients can be cured by non-surgical treatment measures. For old anal fissures, treatment such as anal dilation therapy and anal sphincter release surgery is required, otherwise the possibility of self-healing of the fissure is extremely low. Tips: 1. Develop good bowel habits and treat constipation in a timely manner. 2.The diet should contain more vegetables and fruits to prevent dry stools and avoid coarse and hard stools from rubbing the anus. 3, pay attention to anal cleanliness to avoid infection. It is advisable to treat anal fissures as early as possible to prevent the secondary development of other anal diseases.