In life, many people will have the experience of anal pain when defecating, especially a few days without defecation, when the stool is particularly dry, the pain is especially strong, not only pain when defecating, defecation will continue to hurt after the end of a period of time, a long time to relieve, and sometimes accompanied by blood in the stool, most of the blood on the toilet paper after defecation, most people think they have “hemorrhoids The majority of people think they have “hemorrhoids” and don’t care. It is very painful. So, what exactly is the cause of the above situation? I would like to remind you, do not think that it is “hemorrhoids”, in fact, it is likely to be “anal fissures” in play. What is “anal fissure”? As the name implies, an anal fissure is a fissure in the anal canal. The medical term for a full-length longitudinal fracture of the skin of the anal canal that results in an infected ulcer is anal fissure. Anal fissures have been documented in our ancient classical Chinese medical literature for a long time, and are known in Chinese medicine as “hooked hemorrhoids” and “fissured hemorrhoids”. In the Qing Dynasty? Qikun’s “Surgical Dacheng” records “hooked intestinal hemorrhoids, hemorrhoids inside and outside the anus, fracture, stool like goat shit, bleeding after feces, obscene odor and great pain ……”. The Qing Dynasty? The “Medical Zong Jinjian – The Essentials of Surgical Technique” has a record of “anal fissures around the folds and ruptures, and those who have knots in the stool are also fire-dry”. Anal fissures have three main clinical manifestations: anal pain, bleeding and constipation. Anal pain is the main manifestation of anal fissure, which is mostly caused by constipation and the rupture of the anal canal due to forceful defecation, with pain like cutting or burning pain. This form of pain is medically known as the periodic pain of anal fissure. In anal fissures, blood in the stool is mostly on the toilet paper after defecation, and sometimes you can also see blood dripping during defecation, mostly bright red in color and mostly attached to the surface of the stool. Constipation and anal fissures are causal and affect each other. Patients with anal fissures are often constipated, and if the bowel movement is dry and hard, it can tear the skin of the anal canal and lead to anal fissures. When the stool stays in the anus for a long time, the stool will dry up due to excessive water absorption, which will cause more pain when defecating and further aggravate the fissure, leading to a vicious circle. What are the causes of anal fissure? Western medicine believes that long-term constipation and mechanical injury are the main factors in the formation of anal fissures. Local injury is the direct cause of anal fissures. Dry stools, foreign bodies, childbirth, and excessive force during defecation can all cause damage to the skin of the anal canal, which can lead to anal fissures secondary to infection. The anatomical factors for the formation of anal fissures include high pressure on the posterior wall of the anal canal and poor blood supply to the superficial part of the external anal sphincter. Congenital malformation, trauma or surgery cause narrowing of the anal canal, and the skin of the anal canal is easily torn and damaged by the passage of dry and hard stool, and bacteria invade and form ulcers resulting in anal fissure. Patients with anal fissures have excessive internal sphincter contraction enhancing activity, and reflex internal sphincter contraction is the main factor in the formation of anal fissure pain cycle and one of the main reasons why anal fissures do not heal easily. According to Chinese medicine, this disease is mostly caused by poor diet, excessive alcohol consumption and spicy food, which leads to dryness and heat, depletion of fluids and no downward moistening of the large intestine, or blood deficiency, blood deficiency and lack of fluids and dryness, resulting in blood heat and intestinal dryness or yin deficiency and lack of fluids, constipation and forceful defecation, causing anal skin fissures, dampness and poisonous evil taking advantage of the deficiency and entering the skin and tendons, local stagnation of qi and blood, poor operation and lack of This can lead to anal fissure. Who is prone to anal fissures? In general, people who are susceptible to anal fissures are mainly those who suffer from chronic constipation. Patients with anal fissures are mostly young adults, and the age group with the highest incidence of the disease is 20-40 years old, with a male to female ratio of about 1:2.5, and a higher incidence in women. Excessive alcohol consumption, the like to eat spicy food, sedentary, drinking too little water, poor defecation habits, etc., resulting in excessive retention of stool in the intestinal tract, difficult to discharge, or even a few days a row, every force of defecation led to the creation of anal fissures. Some patients with tuberculosis and Crohn’s disease often develop anal fissures in their anus, and some patients with venereal diseases, blood disorders and colorectal tumors also develop anal fissures in their anus, but these special types of anal fissures are very different from ordinary anal fissures in terms of the location and shape of the fissures. How can I tell if I have an anal fissure? The diagnosis of anal fissures is determined by medical history, clinical symptoms and physical examination. If you have a long history of constipation and have recently developed the above-mentioned symptoms of anal pain, bleeding and constipation typical of anal fissures, you should be highly suspicious of anal fissures and go to the anorectal department of a hospital to further confirm the diagnosis through examination by a specialist. What are the treatment measures for anal fissure? The first treatment for anal fissure is to soften the stool, change bad defecation habits, keep the stool open, drink more water, eat more fiber-rich food, avoid excessive force during defecation, and if necessary, use medication for defecation, such as Western medicine electrolytes, open plug, and Chinese medicine marenza pills and oral solution to promote the smooth discharge of stool. Some patients with early anal fissures can heal on their own based on softening the stool, keeping it open and improving defecation habits. Fumigation method: commonly use fumigation with blood circulation and pain relief, astringent and swelling, etc., or use the medicinal solution as a hot wet compress, or use 1:5000 potassium permanganate solution to sit in the bath after the daily stool. Sitting bath before stool can relax the anal sphincter to reduce the stimulation of fissure by feces; sitting bath after stool can wash away fecal residue, keep local clean, avoid stimulation of ulcer wound by foreign body, improve local blood circulation, reduce spasm of anal sphincter, relieve pain and promote ulcer healing. Compress or plugging method: Various suppositories and creams with the functions of protecting mucous membrane, lubricating intestine, relieving pain and stopping bleeding are inserted into the anus or applied to the affected area, melting under the action of body temperature and acting directly on the affected area to eliminate and improve symptoms, such as various hemorrhoid suppositories and hemorrhoid creams on the market, which are very effective in improving the symptoms of anal fissure and promoting wound healing. Surgical treatment: If non-surgical treatment is ineffective and the symptoms of recurrent fissures gradually worsen, surgical treatment is required. The purpose of surgery is to release the anal stenosis and sphincter spasm, promote the healing of the fissure, and get rid of the pathologically altered tissue. There are different surgical methods depending on the condition of the fissure. Prevention of anal fissure: 1. Develop good bowel habits and treat constipation in a timely manner. 2, the diet should contain more vegetables and fruits to prevent dry stools and avoid coarse and hard stools to rub the anus. 3, pay attention to anal cleanliness, avoid infection, anal fissure should be treated early to prevent the secondary development of other anal diseases.