It is due to large stools and excessive straining during defecation, which causes the skin of the anal canal below the dentate line to rupture. This can also be caused by anal canal stenosis, leading to secondary infections and gradually forming chronic ulcers. The main symptoms include pain during defecation, bleeding, and constipation. Besides seeking medical attention for acute episodes, most cases are primarily managed through home care. So, how do we properly perform home care? I believe we should pay attention to the following aspects:
1. **Smooth Bowel Movements**: Chronic constipation is the main cause of anal fissures. Therefore, maintaining smooth bowel movements is crucial in preventing this condition. Patients should develop a habit of daily bowel movements, set a regular time for defecation, appropriately increase outdoor activities, and if necessary, take mild laxatives such as liquid paraffin or phenolphthalein tablets. Chinese herbal medicines like rhubarb and senna leaves can also be used to brew tea, making stools softer to facilitate defecation. After defecation, soaking in hot water can improve local blood circulation, promote the absorption of inflammation, alleviate pain, and relieve the patient's nervousness, aiding in defecation.
2. **Adjusting Psychology**: Strengthening the education on health knowledge about anal fissures, explaining in detail the pathogenesis, prognosis, and recovery of the disease to patients, can alleviate their tension and enhance their confidence in fighting the disease, thus keeping them cheerful and peaceful.
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4. **Balanced Diet**: Reasonably arranging the diet helps ensure smooth bowel movements. The diet should include more fresh fruits, vegetables, and high-fiber foods, while reducing or avoiding spicy and stimulating diets. Drinking plenty of water ensures abundant digestive fluids in the gastrointestinal tract, which aids gastrointestinal peristalsis and prevents constipation.
5. **Emphasizing Food Therapy**: Regular consumption of high-fiber foods can stimulate gastrointestinal peristalsis and aid in defecation. Some foods with blood-nourishing and bowel-moistening effects, such as longan meat, jujube, walnut, sesame, black fungus, mulberry, and pine nuts, can be consumed regularly. They can also be made into medicinal dietary therapy recipes, such as longan meat porridge, sesame cakes, stir-fried corn with pine nuts, and stir-fried lean meat with walnuts, which can moisten the intestines, facilitate defecation, and promote the healing of fissures.
6. **Maintaining Hygiene**: Keeping the anal area clean, washing the anus after each bowel movement, bathing frequently, and changing underwear regularly can effectively prevent infection. If there is heavy bleeding, seek medical attention immediately. For minor bleeding, strengthen observation and consume blood-nourishing nutritional supplements and foods to enhance the body's resistance.
7. **Persisting in Sitz Baths**: Before and after defecation, use potassium permanganate warm water sitz baths (1:5000), with water temperature at 43℃～46℃. Perform this 2～3 times a day, each lasting 20～30 minutes. Sitz baths can relax the sphincter muscles, reduce pain, improve local blood circulation, promote the absorption of inflammation, and help heal anal fissures. Herbal medicine can also be used in conjunction with sitz baths. Commonly used herbal prescriptions include:
- Prescription 1: Prepared myrrh, herb-graceful, corydalis, red peony root, sophora, and wind-preventing herb, each 20 grams; alum and gallnut, each 10 grams.
- Prescription 2: Dandelion, herb-graceful, viola, honeysuckle, red peony root, phellodendron, and baical skullcap, each 30 grams; alum and gallnut, each 10 grams.
- Prescription 3: Baical skullcap, phellodendron, atractylodes, angelica, ligusticum, salvia, astragalus, white芷, corydalis, each 20 grams; prepared myrrh, each 10 grams; earthworm and pagoda flower, each 15 grams; borneol, 5 grams.
- Prescription 4: Honeysuckle, wild chrysanthemum, fish腥grass, snake tongue grass, each 20 grams; pagoda flower or pagoda angle, 15 grams; bletilla, 30 grams; borneol, 5 grams.
Clean the herbs, place them in a pot, add an appropriate amount of water, soak for 5～10 minutes, boil and extract the juice, pour it into a bath basin, mix in alum or ice pieces evenly, and sit in the bath when warm. Do this 2～3 times a day, each lasting 10～30 minutes, continuously for 1～2 weeks.