Patient Question: Description: Female 27 years old. Constipation for six or seven years, with anal fissure, which has not been treated. Constipation causes anal fissure, which is a vicious circle. I would like to know if I should treat the constipation or the fissure first. Which is better to treat my habitual constipation, Chinese or Western medicine? Can you give a treatment prescription? Doctor: The principles of treating anal fissures: laxative, pain relieving and healing, and promoting the healing of fissures. When the stool is well regulated, the treatment of anal fissure will be effective. There is no contradiction in treating anal fissure and constipation together. Suggestions: Click here to refer to my article “Self-treatment of anal fissure patients” Suggestions: Click here to refer to my article “What are the causes of constipation” You check thyroid function (blood sampling). Patient question: What tests are usually done for constipation? If a Chinese doctor looks at it, will he also need to do a lot of instrumentation. Reply from Mei Xiaoling, Department of Anorectal Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine: Constipation can be a separate disease or a manifestation of other diseases. There are many causes of constipation, and symptomatic treatment can be effective at the time, but constipation can still occur after stopping the medication. I recently saw a female patient who had been constipated for more than 10 years. She lived in the cardiovascular ward of the Department of Internal Medicine and had undergone two hemorrhoid surgeries over the past 10 years due to difficulty in defecation, and now she still struggles to defecate and is in great pain. Today’s thyroid function test showed that the patient had severe hypothyroidism. Thyroid hormone is a metabolic hormone, and the body metabolizes it too slowly when this hormone decreases, so it is hard to defecate. The patient’s family said: all these years taking constipation medicine all day long and no one reminded to check the thyroid function. I think that regardless of the Chinese medicine and Western medicine should first find out the cause of constipation in order to have good results.