I. What is anal fissure? An anal fissure is a longitudinal fracture of the entire skin of the anal canal and the formation of an infected ulcer. The disease is more common in young adults, more women than men. The site of anal fissure is usually in the front and back of the anus, especially in the posterior position, and is clinically characterized by periodic anal pain, bleeding and constipation. In Chinese medicine, this disease is called “hooked intestinal hemorrhoids”, “fissured hemorrhoids” and so on. What are the symptoms of anal fissure? 1, pain: periodic pain is the main symptom of anal fissure, often due to the expansion of the anal canal during defecation to stimulate the ulcer surface, triggering tearing-like pain, or burning pain, or cutting-like pain, which lasts for a few minutes to reduce or relieve, known as pain interval, generally in about 5min; then the sphincter continued spasm contraction and severe pain, which can last for several hours, making the patient restless, very painful, until the sphincter fatigue After relaxation, the pain is gradually relieved, and this process is the anal fissure pain cycle. In serious cases, coughing and sneezing can cause pain, which radiates to the pelvis and lower limbs. 2. Bleeding: bleeding during stool, not much, bright red, sometimes staining the stool paper, or adhering to the surface of stool, sometimes dripping blood. Constipation: Most of the patients have habitual constipation, and they are reluctant to defecate regularly because of the fear of pain during stool, so constipation is aggravated, forming a vicious circle. What are the complications of anal fissure? If the anal fissure is not treated at an early stage, the infection continues to cause inflammation and edema in the tissue around the fissure. Inflammation spreading upward from the ulcer stimulates tissue hyperplasia to form anal papilla hypertrophy, and downward spreading inflammation stimulates connective tissue hyperplasia at the anal outlet to produce external hemorrhoids. In severe cases, the inflammation may become septic, break down into the skin and flow pus, and form purulent sinus tracts. The formation of subcutaneous low anal fistula. Fourth, the relationship between anal fissure and constipation? The cause is mostly due to dry stool. The fissure is caused by a series of pathological changes such as fissures, swelling and swelling, which are caused by cutting the skin of the anal canal when the dry stool is removed by force. After the development of anal fissures, patients are afraid to defecate for fear of pain, and a vicious cycle of “fear of pain – tolerate stool – dry stool – more pain” occurs. The vicious cycle of “pain – stool – dry stool – more pain” occurs. Therefore, soft and smooth stool is of great significance to prevent anal fissure disease. Can anal fissures heal on their own? 1. Early anal fissure: superficial longitudinal fissure of the skin of the anal canal, with neat edges, fresh base, red color, obvious tenderness and elasticity of the wound surface. Early anal fissures do not require surgical treatment. Keeping the stool open and cleaning the anus after the stool can make the fissure heal. 2, old stage anal fissure: most have a history of repeated attacks. The traumatic edge is irregular, thickened, poorly elastic, with a purplish red ulcer base or purulent discharge, and an enlarged anal papilla at the upper end adjacent to the anal sinus; the lower end of the traumatic edge has sentinel hemorrhoids or a subcutaneous fistula. Old anal fissures form ulcers over time, and infection causes edema and hyperplasia of the tissue around the ulcer, requiring surgical treatment. Prevention and care of early anal fissure 1, keep the bowels open, develop good defecation habits, timely treatment of constipation. 2, dietary conditioning, to drink less, do not eat spicy stimulating food, food should not be too fine, coarse and fine grains with vegetables and other fiber-rich food as much as possible, can keep the stool normal. 3, pay attention to anal cleanliness to avoid infection. Early detection of anal fissures to keep clean can accelerate the healing of the fissure and prevent the secondary development of other anal diseases.