? As mentioned earlier, anal fissures are due to a combination of causes, and dry and hard stools are the direct cause of anal fissures. Young adults are most likely to have dry and hard stools, so the incidence is higher in young adults. Food intake to stool excretion is a very complex physiological process. Normal bowel movement is closely related to a reasonable dietary structure and good bowel habits. The lack of coarse fiber in the diet, such as vegetables and fruits, too much meat, and the uneven mix of coarse and fine grains will make the stool dry and hard to solve, while excessive consumption of spicy and irritating things such as chili peppers and drinking alcohol will also make the stool dry. The discharge of feces and intestinal peristaltic power, people in the early morning after waking up and after eating a period of time, the intestinal peristaltic contraction force is greater, down to push the feces, at this time defecation is easy and effortless, while other times defecation is more effort. Young adults due to work, study pressure, heavy burden of life, easy to ignore a reasonable diet, coupled with poor dietary habits such as chili peppers, like drinking alcohol, etc., the stool is easy to dry and difficult to solve. At the same time, they cannot defecate normally on time, making defecation laborious, and some of them can hold back their bowel movements for several days, and the stool stays in the rectum for too long, and the water is absorbed and becomes dry and hard. Bad habits, such as irregular living habits, less exercise is a common phenomenon among young adults, is also one of the factors that cause dry stools, defecation difficulties. Young women, due to physiological reasons, such as the onset of menstruation, pregnancy, childbirth, etc., is also prone to dry stools and difficult to discharge. From the above, it is easy to see why young adults are prone to anal fissures. Do anal fissures require surgery? In clinical practice, doctors decide whether to take surgical treatment based on the severity and duration of the condition. If the fissure is short, less than 3 days old, it can be restored to normal by adjusting the diet, improving bowel movements, and taking hot water baths after the bowel movement. If the onset of fissure is more than 3 days, but the fissure is fresh and shallow, with neat edges and no scar formation, that is, stage I fissure can be cured by non-surgical treatment. Patients with anal fissures who are temporarily inoperable due to chronic systemic diseases should focus on symptom control. For anal fissures caused by chronic diseases, the primary disease must be actively treated to control the symptoms of anal fissures. What is the relationship between anal fissure and sentinel hemorrhoid? Sentinel hemorrhoids, also known as anterior sentinel hemorrhoids, are connective tissue external hemorrhoids that occur at the outer end of the anal fissure, just like a sentinel standing at the outer end of the fissure. The skin at the lower end of the fissure is stimulated by fecal impact, fecal residue and secretions, bacterial infection, inflammatory changes, venous and lymphatic return obstruction, causing edema and fibrous tissue proliferation, resulting in external hemorrhoids. Sentinel hemorrhoids are the pathological product of long-term non-healing of anal fissures.