Anal fissures are both anal canal ruptures and are common and frequent in anorectal medicine. The main manifestations are blood in the stool and pain, and blood and pain in the stool can occur periodically with each bowel movement. Blood in the stool is commonly stained with blood from hand paper, or dripping blood, or shooting blood. Pain is a tearing pain caused by the passage of stool through the anal canal fissure, which can last for several hours and then be relieved. The pain varies depending on the degree of injury, severity of infection, and individual sensitivity of the anal fissure. Causes of anal fissures 1. Stool: The most common cause is constipation, which causes the anal canal to be torn when dry, thick, hard stool passes through the anus. Or often diarrhea, or squatting for too long, or when the stool hard to struggle, etc. can easily lead to anal fissure. 2, inflammation: due to constipation, diarrhea, trauma and other damage to the anal canal, fecal stimulation infection can form ulcers; due to chronic inflammation of the fissure so that the anal sphincter muscle spasm, resulting in anal elasticity is reduced, the anus becomes smaller, when the stool is more likely to lead to anal tears, forming a vicious circle. 3, perianal disease: such as anal sinusitis, anal papillitis, perianal dermatitis, etc. can also stimulate the anal canal skin, subcutaneous tissue and sphincter, resulting in these tissues become brittle, decreased elasticity and sphincter spasm, thus prone to anal fissure. 4, other: such as anal congenital narrow, anal trauma (anal examination, picking stool, etc.), anal surgery scar too much poor elasticity, etc., are prone to anal fissure. Treatment of anal fissure 1. Internal treatment: It is to adjust the stool and relieve the symptoms of pain and bleeding through oral medication, but it cannot treat anal fissure at the root. For example, Chinese herbal medicine treatment under the guidance of Chinese medicine diagnosis and treatment, or treatment with Chinese and Western medicines such as Sophora pill, Ma Ren pill, Diosmin tablet, Mai Zhi Ling, etc., which have the functions of laxative, hemostatic and pain relief. It is suitable for stage I and II anal fissures and can eliminate symptoms and promote wound healing. 2.External treatment: both “anal local administration” and “local rubbing” and sitz bath. Topical medication plays the role of hemostasis, anti-inflammation, analgesia and promotion of wound healing. For example, topical Chinese medicines include Ma Yinglong hemorrhoid cream, Jiuhua cream, Tai Ning pessary, hemorrhoid pessary, etc.; sitz bath can use Chinese decoction or Chinese medicine, such as: Jin Xuan hemorrhoid fumigation, Rishuan, Ganlin lotion, etc. 3.Surgical treatment: Generally speaking, for stage I anal fissure, if pain and bleeding occur once in a while, surgery is not necessary, and internal or external medicine can be used to regulate the stool, anti-inflammatory and pain relief. For stage II and III anal fissures (old fissures) that do not heal for a long time after conservative treatment, surgery is often required. The main surgical methods are: anal fissure excision, internal sphincter release (open or closed release), etc.