Patient Question:Disease:Old anal fissure? Description:Anal fissure appeared in early April, bleeding, painful, radiating left buttock, sometimes very painful. Afterwards, I used some creams to relieve it. After a period of medication, and insisting on eating a lot of fruits, the situation used to be better. However, in recent days, the stool was getting less and less again, and although it was not really dry, the anal fissure that had been still there was significantly painful and bleeding again. A local chief physician said that it was an old anal fissure and that surgery would be better. I read the exchange of patients and found that the results of this surgery were indefinite and prone to recurrence. The inpatient recovery period may also drag on for ten days. I don’t know what to do is the right thing to do. Hope to help: First of all 1. is this diagnosed as old anal fissure? 2. Is it also chronic anal fissure? If not, 3. what is the problem? 4. Is surgery necessary? 5.What is the best option for surgery? 6.What is the prognosis of surgery? Is it prone to recurrence? 7.Is there any feasible and effective conservative treatment? 8.What causes this problem? There are a lot of questions, thanks for your hard work. Doctor: You need to stop aspirin for 7 days after surgery, take aspirin to bleed more during surgery also bad to stop bleeding. You should ask for a cardiology consultation before surgery. The fissure is a chronic anal fissure, usually with a deep fissure, not a fresh, pale base, thick involution of the fissure edge, a dermatome at the outer end of the fissure (sentinel hemorrhoid), a hyperplastic and hypertrophic anal papilla at the proximal end of the anal fissure, and in some cases, an anal fistula. The anal fissure is very easy to recur, you may be the onset of the fissure in April has not been well and aggravated. The anal pain of anal fissure usually does not radiate to the left buttock, is it accompanied by anal sinusitis? The prognosis after surgery is good, and there is usually no recurrence after surgery. The pain after surgery is less than doing a mixed hemorrhoid because the pain is not as heavy with the severed sphincter. The cause of anal fissure is a chronic ulcer formed by a dry, hard stool that breaks the anal canal.