Pain There are two types of pain after anal surgery, reflex pain and inflammatory pain. Because the human anal region is rich in nerves and innervated by the cremaster nerve, pain is very sensitive, so surgical trauma and inflammatory stimulation can lead to pain. Pain can be caused by the following reasons: 1. Patients are extremely sensitive to pain due to fear, and the anal sphincter is in a state of tension, so the slightest stimulation can cause pain. This pain mainly occurs during surgery and post-operative medication changes. 2.Postoperative infection, edema of the wound, constipation and foreign body stimulation can also cause pain. 3.Small anal canal, pain caused by tearing the skin of the anal canal by force when defecating. 4.The traumatic surface is large, and the scar is too heavy after healing, and the scar contracture compresses the nerve endings and causes pain. Treatment: No treatment is needed for mild pain. Those with severe pain should be treated according to the situation, such as oral or injectable painkillers. Those who have difficulty in defecation can use corked milk to assist defecation. Anti-inflammatory treatment is feasible for inflammatory pain. Edema Anal edge edema is also a common reaction after anal surgery, and edema can intensify anal pain, and edema occurs for a variety of reasons. 1, too much anal margin tissue is removed or ligated during surgery, too many incisions and unreasonable selection of incisions, etc., resulting in impaired local blood and lymphatic reflux, increased vascular permeability, and water retention in the tissue interstices. 2.Inadequate stripping of venous mass at the anal verge. 3.Uneven filling of postoperative dressing and difficulty in urination and defecation, squatting for too long. Treatment: Mild edema can be absorbed slowly on its own, so there is no need to trim it repeatedly. It can be taken orally, and a wet dressing of 40% hypertonic saline can be used for local dressing changes. If the edema is very large, a decompression incision can be made surgically. The main reasons for abdominal distension after anorectal surgery are: 1. anesthesia, especially lumbar anesthesia and sacral anesthesia are obvious, appearing on the day after surgery. 2, too many dressings wrapping the wound too tight, so that the anus can not exhaust. 3.Postoperative bed rest and poor intestinal peristalsis. 4.Over-eating milk, sugar and other foods. Treatment: Apply hot compresses to the abdomen first, and after seeking the doctor’s consent, loosen the bandages wrapped around the incision appropriately, or ask the doctor to give the anal canal exhaust, and if necessary, take oral physiotherapy to help digestion. Fever 1.Intraoperative blood loss, sweating and fluid loss, and decrease in body resistance, resulting in fever and cold. 2.The reaction of drugs used during the operation. 3.Infusion reaction. Treatment: first find out whether it is a local infection, which can generally be confirmed by routine blood tests and local examination of the anus. If the infection is localized, surgical incision of the infected area and systemic anti-infection should be performed in a timely manner. If the infection is not local, consider other causes and give symptomatic treatment. If there are no other symptoms and signs, and the temperature does not exceed 38°C, it should be considered as drug absorption fever, which does not require special treatment and can generally resolve on its own in 5-7 days. Blood in the stool Anal surgery is mostly open wound, mainly using local pressure to stop bleeding, a few days after surgery, each time a small amount of bleeding during defecation, after the stool since the stop, is normal. If the bleeding does not stop, you should seek immediate medical attention. There are the following reasons for blood in the stool after anorectal surgery: 1. the ligature line falls off after surgery. 2.The wound was not tightened when it was wrapped. 3. Defecation on the same day after surgery. 4.Patients combined with medical diseases with bleeding tendency, such as leukemia, coagulation factor deficiency, liver cirrhosis, hypertension, etc. Treatment: first identify the cause of bleeding and bleeding site, localize the bleeding point by pressure bandage or ligation, systemic hemostatic drugs, and appropriate amount of antibiotics. In case of more blood loss, rehydration, blood transfusion and correction of water-electrolyte acid-base balance should also be used. Ask the patient to control the stool and rest in bed as much as possible. Difficulty in defecation 1. Patients have fear of anal pain caused by defecation and intentionally prolong defecation time, so that water in the stool is excessively absorbed and dried up, resulting in difficulty in defecation. 2, Excessive intraoperative tension and sympathetic excitation inhibit intestinal peristalsis. 3, Postoperative bed rest and reduced activity slow intestinal peristalsis. 4.Low fiber in the diet. Treatment: The first bowel movement after anorectal surgery can be assisted by corked laxative, and later some laxatives or stool-softening drugs can be taken for prevention. Difficulty in urination 1, anesthesia factors: anesthesia dulls or disappears the sensation of bladder expansion, and the bladder over-expands and loses tension. 2, urethral sphincter spasm: postoperative anal pain, so that the anal sphincter spasm, because the anal sphincter and urethral sphincter are the same innervation, the result is that the urethral sphincter also spasm. 3.Changing urinary habits after bed rest 4.Excessive filling of the anal local or intestinal cavity dressing, compressing the urethra. Treatment: 1, hot water bag on the small abdomen and anal perineum. 2.Stimulation by artificial water drops to cause conditioned reflex and enhance the sense of urination. 3.Release the bandage after seeking the doctor’s consent. 4.Inject neostigmine 0,5-1mg intramuscularly. 5.In the midline of the abdomen four fingers below the umbilicus, press down vertically with the fingertips for a moment, and go to urinate when the feeling of urination arises. 6.Overfilled bladder, use catheterization. Anal itching 1, the normal reaction of the wound healing process, generally in the late healing stage, the wound crawl skin, the wound edge can be itchy, without treatment can slowly disappear. 2, one is allergic to postoperative topical creams or lotions, can appear perianal skin flushing, pimples, etc. 3.Surgery destroys the anal glands, and the anal gland fluid flows out to stimulate the perianal skin, or surgery damages the anal sphincter, so that the anal closure is not tight, and the intestinal fluid leaks out to stimulate the perianal skin. Treatment: 1. Keep the area dry. Avoid alcohol, chili and seafood. 2.Pepper salt water sitz bath. 3.External application of paregoric pine (no more than 5 days), tylenol cream, etc.