Zhang, male, 28 years old. For three months, he always had blood dripping after defecation, anal mass prolapsed during defecation, and the mass disappeared after defecation without pain. Recently, the amount of blood in the stool increased and he felt dizziness, fatigue, and poor spirit, so he went to my specialist clinic for medical treatment. Physical examination revealed that the patient was anemic in appearance, and based on experience, there was severe anemia from the fingernail cover and eyelids, and the hematocrit would not be more than 6 grams (the hematocrit was confirmed to be 5.5 grams in the laboratory), and anal examination with anoscopy, combined with the history and complaints, diagnosed him with: 2nd degree internal hemorrhoids combined with iron-deficiency anemia. I asked him why he did not seek treatment earlier. The patient said, he looked up on the Internet, estimated that the cause of bleeding is hemorrhoids, thinking that this is a benign disease, and see the Internet others say that this surgery is very painful, and will recur after the operation, he is young, so bear with it and maybe it will be fine. I didn’t realize that it was getting heavier and heavier, and now I can hardly go to work, I can’t catch my breath when I walk a little faster, I have to take a break in the middle of going up the stairs, and I have to seek medical attention. My advice was to hospitalize him, first correct the anemia, and then operate as soon as possible. He agreed. Surgery, there will be pain, this is an indisputable fact, especially anorectal surgery, some people also ranked the pain of anal surgery in the first of all kinds of pain. But like Xiao Zhang so would rather long pain and avoid the short pain of patients are not a few, and finally long pain short pain one is not less, to bring greater difficulties in treatment, their own recovery is slower, spend more money. Now and Zhang have the same idea of many patients, often encountered in the clinic, really should have been treated, but is delayed again and again, there is a reason: fear of pain. Anal surgery is really so horrible? First, why the pain of anorectal surgery makes people afraid of Surgery will be painful, why only the pain of anorectal surgery to make people afraid of, and heard of the color? This is mainly due to the special characteristics of the anorectal decision. 1, the anus feel sharp: because the anus of the sensory nerves are densely packed, the anus is more sensitive than other parts of the body to a variety of stimuli. 2, anal sphincter spasm: anal sphincter is divided into internal sphincter and external sphincter, the internal sphincter is a smooth muscle, which is characterized by very easy to spasm and is not subjective consciousness control, when in the exposed state, by the intestinal secretion, feces and other stimuli, will involuntarily spasm, spasm will aggravate the local ischemia and edema in the anus, so that the pain is aggravated. 3, defecation: the anus will repeatedly expand and contract during defecation, pulling the surgical wound and aggravating the pain. At the same time if the feces is abnormal, dry or diarrhea will also stimulate the wound. So many anal patients call postoperative defecation over, some people even hope to escape this hurdle by fasting to control defecation. But this is wrong, on the one hand, fasting leads to nutritional deficiencies will affect wound healing, on the other hand, the anus also needs to be repaired in the “active” state does not affect the future function, will not lead to anal stenosis. Second, the classification of anorectal surgery pain postoperative anal pain is broadly divided into the following four, a patient’s pain may belong to one or more of the nature. 1, trauma pain: is due to anal surgery more open wounds without suture, nerve endings exposure caused by. Characterized by the degree of pain and surgical incision how much and the size of the wound is directly proportional to the time will gradually reduce or disappear. 2, sphincter spasm pain: due to excessive tissue damage, trauma, tissue edema or thrombus stimulation, can lead to spasm of the internal anal sphincter, resulting in severe pain. Occurring in the days after surgery, the pain is intense, unbearable, persistent or rhythmic, some patients describe it as a paroxysmal convulsive pain, severe cases will be combined with urination difficulties. Inflammatory pain: postoperative anal edema, thrombus, infection can also induce pain. Mostly occurs in a few days after the operation, sudden onset, the degree of pain is heavier, with the prolongation of time will be reduced. 4, scar pain: is caused by the scar after the healing of the surgical wound, the heavier the scar the more likely to appear. Generally appear in the postoperative month, manifested as a transient pinprick pain, the degree is not heavy. Third, the countermeasures of anorectal surgery pain Understanding the mechanism and classification of pain, we can analyze the reasons for the occurrence of pain, prescribe the right medicine for different kinds of pain to make the appropriate treatment. First of all, the pain after anal and intestinal surgery, prevention is the main focus, surgical operation should be stable, accurate, fast, fine, to minimize the damage to the anal canal area; choose the appropriate anesthesia method, master the anesthesia technology; attention to prevent stenosis during the operation; postoperative defecation can be applied to soften and laxative drugs. It is reported that intraoperative internal sphincterotomy or anal dilatation can reduce pain, however, the elderly use this method with caution. If intraoperative found accompanied by anal fissure or anal stenosis, or surgical incision more postoperative anal stenosis Konen, can be attached to the above methods, general patients are not recommended to use. Treatment of postoperative pain, there are a variety of analgesic drugs, analgesic pumps, the end of the operation before the end of the local use of long-acting analgesic drugs, such as methylene blue. Postoperative physical therapy, Chinese medicine fumigation, sitz bath and so on can also reduce pain. In short, with the progress of medicine, anorectal surgery to achieve “pain-free” is still difficult, but more and more means of pain relief, the effect is getting better and better. Post-operative pain on the anorectal surgery to produce excessive fear is completely unnecessary, and do not delay the treatment of disease, a small disease into a big disease. Long-term pain is better than short-term pain, there is a disease or timely medical treatment.