Symptoms of anal fissures: Patients with anal fissures have the typical clinical presentation of pain, constipation and bleeding. The pain is mostly severe and has a typical periodicity. Patients will immediately feel burning or knife-like pain in the anus during defecation, which is called pain during defecation; it can be relieved for a few minutes after defecation, which is called intermittent period; then severe pain again due to contraction and spasm of the anal sphincter, which can last for half to several hours, which is clinically called sphincter contracture pain. The pain is relieved after the sphincter is fatigued and relaxed, but the pain occurs again when defecating again. The above is called the anal fissure pain cycle. Patients are reluctant to defecate for fear of pain, which in time leads to constipation and drier stools, which in turn aggravates the fissure, forming a vicious cycle. A small amount of blood or drops of fresh blood is often seen on the surface of the stool or on the stool paper during defecation, and heavy bleeding is rare. Acute or incipient anal fissures can be treated with a sitz bath and moisten the stool, chronic anal fissures can be treated with a sitz bath, moisten the stool and dilate the anus; those who do not heal for a long time, conservative treatment is ineffective and the symptoms are heavy can be treated with surgery. The treatment of anal fissure: 1. General treatment The principle of non-surgical treatment is to release the spasm of the sphincter, relieve pain, help defecation, interrupt the vicious cycle, and promote local wound healing. Specific measures are as follows: after defecation, take a sitz bath with 1:5000 potassium permanganate warm water or light salt water to keep the area clean; take oral laxatives or paraffin oil to loosen and lubricate the stool; increase drinking water and multi-fiber food to correct constipation and keep the stool open; after local anesthesia for anal fissure, the patient lies on his side, first dilate the anus with the index finger and then gradually extend the two middle fingers to maintain dilation for 5 minutes. The dilation can release the spasm of the sphincter, expand the trauma, and promote the healing of the fissure. However, this method has a high recurrence rate and can be complicated by bleeding, perianal abscess, fecal incontinence, etc. 2, surgical treatment (1) anal fissure resection that is to remove all the proliferating fissure edge, sentinel hemorrhoids, hypertrophic anal papillae, inflamed crypt and deep unhealthy tissue until the exposure of the anal canal sphincter, can simultaneously cut off part of the external sphincter subcutaneous or internal sphincter, open wound drainage. The disadvantage is that healing is slower. (2) Internal sphincterotomy is a circular, involuntary muscle, and its spastic contraction is the main cause of anal fissure pain. The procedure is to make a small incision 1-1.5 cm from the anal edge on one side of the anal canal to reach the lower edge of the internal sphincter, determine the intersphincter sulcus, separate the internal sphincter to the dentate line, cut the internal sphincter, then expand it to 4 fingers, electrocautery or compression to stop bleeding, and then suture the incision. This method has a high cure rate, but improper surgery can lead to anal incontinence.