In the anorectal clinic, we often encounter patients who come to the clinic with the main complaint of “anal swelling and discomfort”, and most of them lack typical positive signs. What exactly is “anal swelling”? How should it be treated? It is a symptom of discomfort that occurs in the rectum, anus and perineum, often secondary to other anorectal diseases, mainly manifesting as: anorectal cramping, distension, foreign body sensation, bowel sensation, burning sensation, and in severe cases, even radiating to the distal perianal area. The disease is often prolonged, very difficult to treat, the efficacy is not exact, and the proportion of recurrence is high. The causes of this disease are very complex, and the reasons for them are mainly the following. 1, anorectal prolapse disease: such as II, III degree to prolapse mainly hemorrhoids and rectal mucosa prolapse, women are more common, the former manifested as repeatedly prolapsed out of the anus hemorrhoids, the latter manifested as rectal mucosa relaxation accumulation in the rectum, but not yet off to the anus, can cause anal swelling and defecation feeling. This is equivalent to the discomfort of anal swelling caused by “Qi deficiency and subsidence” in Chinese medicine. 2, anorectal inflammation: inflammation is one of the main causes of anal bloating. The common ones are anal sinusitis, because the inflammation stimulates the tooth line and pelvic floor nerves, it is manifested as anal swelling, burning sensation in the anus, because the lesion in the anal sinus, anoscopy can be seen in the anal sinus congestion, or a small amount of purulent secretions overflow, press here there is a soreness. The proctitis is characterized by frequent bowel movements, a sense of incomplete defecation, increased bloating during defecation, with thin stools, or mucus and blood. 3, constipation: mainly part of the exit obstruction type constipation caused by anal swelling, such as pelvic floor relaxation, perineal descent or in severe cases, pelvic floor hernia, resulting in pelvic or small intestinal organs prolapse, compression of the rectum, causing the swelling discomfort. 4, perianal abscess: high perianal abscess due to the abscess location is deep, some deep to the anal raphe, pain is often not obvious, manifested as swelling, cramps or rectal irritation symptoms. 5.Functional anorectal pain: some patients show mainly anal swelling, the disease is divided into chronic anal pain and spasmodic anal pain, the former pain is usually vague dull pain, electric shock-like, tearing-like, burning-like pain, the attack can last for several hours to several days. The latter is a sudden and severe pain in the anal area, which lasts for several seconds or minutes, and then disappears completely. 6, anorectal neurosis: mental trauma, misinformation or local pain stimulation, resulting in cortical dysfunction, plant nerve dysfunction, local nerve dysfunction, anorectal sensory abnormalities. In Chinese medicine, it is called “depression”, which is caused by lack of heart energy and deficiency of heart blood due to emotion and depression. 7, other diseases: gynecology, such as chronic pelvic inflammatory disease, manifested as perineal, anal pain, exertion or menstrual pain increased. The male prostate gland is adjacent to the rectum and anus, inflammation and hypertrophy will cause some stimulation to the rectum, which can also be manifested as anal swelling. Orthopedic diseases such as coccygeal lesions or trauma can also cause anorectal distention. In the prevention of anal bloating, first of all, diet, avoid cold, cold food, spicy and stimulating food and alcohol, with the appropriate amount of physical exercise, relaxation, avoid excessive attention. For the treatment of anal swelling, appropriate anti-inflammatory treatment is possible, but the choice of drugs and the timing of medication should be grasped, absolutely no abuse of antibiotics, Chinese medicine dialectical treatment can play a better role, surgical treatment needs to be cautious.