2020年10月28日星期三

what does a hemorrhoids look like,Pay attention to preventing anorectal diseases in summer

    After the beginning of summer, with the rise in temperature, the incidence of some damp-heat-related diseases is also increasing. Anorectal diseases bear the brunt: blood in the stool, anal pain, prolapse of objects in the anus after the stool, anal itching, anal dampness, diarrhea, abdominal distension, A series of symptoms such as abdominal pain and constipation make people unable to sit and sleep peacefully...

    All these are symptoms of anorectal disease. Anorectal diseases occur in special parts and cannot be ignored as well, otherwise the consequences are endless.

    These symptoms help you self-diagnose

    If you see bleeding, dripping, or blood or pus in the stool, it is mostly caused by anorectal disease. However, different anorectal diseases have different symptoms. The following will teach you a brief judgment:

    Hemorrhoids with blood in the stool are often painless and the blood is bright red;

    Anal fissure bleeding is bright red, often accompanied by anal tear-like pain;

    Stool with blood, bright red or dark red, accompanied by changes in bowel regularity, which may be caused by ulcerative colitis, Crohn's disease, intestinal polyps or colorectal cancer;

    A mass that protrudes out of the anus during defecation, accompanied by moist or mucus in the anus, most of which are prolapsed internal hemorrhoids or rectal mucosa;

    If the swelling next to the anus is protruding, the pain is obvious, and the boundary with the surrounding tissues is clear, it may be suffering from thrombotic external hemorrhoids or inflammatory external hemorrhoids;

    The lumps around the anus are diffuse with local fever and pain or even increased body temperature, which is a symptom of perianal abscess;

    An ulcer around the anus, repeated discharge of pus, and induration or cords on the touch are the manifestations of anal fistula;

    Increased frequency of bowel movements, or loose stools that cannot be formed, or diarrhea after eating cold food in hot weather, or diarrhea after drinking beer, which may be irritable bowel syndrome or chronic inflammation of the colon;

    The decrease in the frequency of bowel movements, or prolonged defecation time, or consciously intentional defecation but unable to discharge on its own, relying on drugs or hands to help defecation, may be constipation caused by various reasons.

    Anorectal diseases should be diagnosed and treated early

    There are more than 100 kinds of anorectal diseases. The clinical manifestations of some diseases may be similar to the symptoms of hemorrhoids, but their diagnosis and treatment may be completely different. Especially if rectal cancer, venereal diseases, etc. are mistaken for hemorrhoids, the consequences will be disastrous. Therefore, early, timely, and thorough treatment of anorectal diseases should not be delayed; a large hospital, preferably a specialized hospital, should be selected for timely inspection or guidance.

    Some patients are conservative in thinking and feel that anorectal disease is unspeakable, and the affected area is more secretive, and they are not as embarrassed to see a doctor. Especially women, they often buy medicine in pharmacies privately or listen to the so-called folk prescriptions, resulting in prolonged or even worsened conditions, such as anal fistula failure. Transformed into complex, internal hemorrhoids or rectal mucosa repeatedly prolapse, causing itchy skin and anal eczema, blood in the stool for a long time, resulting in anemia, and rectal cancer blood in the stool is mistaken for hemorrhoids. Standard treatment varies from person to person

    Regarding the treatment of anorectal diseases, regular treatment should be adopted according to the condition. For example, there are various hemorrhoids treatment procedures. The characteristic therapies include internal hemorrhoids and Xiaozhiling injection, mixed hemorrhoids external peeling and internal ligation, severe circular mixed hemorrhoids segmented ligation and radical resection, hemorrhoids circular mucosal resection and hemorrhoid suspension (PPH), etc. The individualized surgical plan is designed for the condition of the disease, and the effect is good.

    For the treatment of perianal abscess, we can use traditional Chinese medicine thread-drawing therapy, one-time radical treatment, to avoid the disadvantages of secondary surgery for postoperative anal fistula. The thread-hanging therapy takes advantage of the chronic cutting of the rubber band and repairs while cutting. It is of great significance to reduce tissue damage and protect anal function. It can also treat high anal fistulas.

    For intestinal diseases, in addition to oral Chinese medicine for syndrome differentiation and treatment, it is often effective with enema. In addition, physical therapy, acupuncture, cupping, umbilical application, foot bath, acupoint embedding, ointment therapy and other therapies with characteristics of traditional Chinese medicine are very good auxiliary treatments The role of.

    Prevent anorectal diseases in summer

    Summer is the season of high incidence of anorectal diseases, and the condition will continue to aggravate as the temperature and humidity increase. Therefore, it is very important to pay attention to the following points in life:

    ★Develop good living habits.

    (1) Maintain optimism. Chinese medicine believes that changes in emotions are closely related to anorectal diseases. Excessive anxiety will damage the spleen and stomach, or be irritable and anger will lead to stagnation of liver qi, leading to stagnation of qi and blood, blockage of meridians, and interlacing of collaterals and hemorrhoids.

    (2) In terms of diet, do not be greedy for cold drinks due to the hot weather, do not eat food in the refrigerator directly, do not drink a lot of alcohol, eat hot peppers and mustard and other irritating foods, eat less salted, smoked roast, high-fat, high-sugar foods . Eat more whole grains, beans, vegetables, watermelon and other fresh vegetables and fruits that contain more cellulose to increase bowel movements, eliminate harmful substances and carcinogens in the intestines, and maintain smooth stools. Those with habitual constipation should especially follow these in principle.

    (3) Develop the habit of defecation regularly every morning, drink a glass of cold water after getting up early to stimulate gastrointestinal peristalsis. Especially when you want to defecate, you can't force it. Don't read books or newspapers, squat for a long time, or use excessive force during defecation. Usually, take part in sports activities. For example, gymnastics, running, Tai Chi, Qigong, deep breathing activities and sit-ups are good for preventing constipation.

    (4) It is easy to sweat in the hot summer, and you should develop a habit of loving cleanliness and keep the local area clean and dry. Clean the perineum and anus with warm water after defecation and before going to bed, change underwear frequently, and use thin and soft cotton cloth for underwear.

    ★ Actively treat chronic diseases, such as chronic diarrhea, constipation and other chronic diseases closely related to the anorectum.

    ★Due to work, you need to stand for a long time, squat for a long time, sit for a long time and other tasks that affect the local blood circulation. You should try to do a certain amount of time according to the situation. development of.

    ★ Women perform appropriate exercises after delivery, such as massage, levator anus, improve local blood circulation, and enhance the function of anal sphincter.

    ★ Do levator anus exercises every morning and evening for 30 minutes each time to increase muscle tension and reduce the occurrence of anorectal diseases such as hemorrhoids or prolapse.

    There are many ways to prevent anorectal disease. As long as you pay attention to doing it in your daily life, you can not only prevent and reduce the occurrence of anorectal disease, but also reduce symptoms and reduce the number of attacks for people who already have anorectal disease.

    recoverPOrder(16); recoverPOrder(17);

what does a hemorrhoids look like,Frequent levator ani exercises may have several benefits for your body, but are you doing it right?

    The levator anus exercise is an action that inhales upwards, lifts the anus up, and then relaxes. This exercise does not need to resort to any other sports equipment, it is an exercise that can be done anytime, anywhere. Is the levator movement so simple? What is the use of doing levator exercises? But in fact, doing levator ani exercises often has a great health effect on the body. For men, it helps men protect their prostate health. For women, gynecological diseases can be prevented to a certain extent. So what is the correct way to do the levator ani exercise? Any precautions? What are the benefits of regular levator exercises for the body? What are the benefits of levator ani exercise for the body? ……What are the benefits of levator ani exercise for men? ……What are the benefits of levator ani exercise for women? …… What should I do for levator ani exercise? What are the precautions? ............

hemorrhoids treatment cream,Eight important points of perianal eczema care

    Many diseases are difficult to cure, especially anorectal diseases. General treatment methods are difficult to eradicate. Good diet and health care are necessary. After cure, it is easy to relapse. Active health care can also be used as a preventive treatment. These are the eight important points of perianal eczema care, I hope perianal patients pay attention to it.

    How to care for patients with perianal eczema

    1. Taboos: Avoid spicy, seafood, dog meat, beef and mutton. Regarding taboos, there are also different opinions. Some people believe that taboos should be determined by individual differences. Blindly taboos will cause the human body to lose a lot of nutrients and adversely affect the disease. I think appropriate taboos are still necessary, especially during the period of taking therapeutic drugs. Overall, the advantages outweigh the disadvantages.

    2. Hemolytic streptococcal infection is a predisposing factor of this type of disease. Avoid colds, tonsillitis, and pharyngitis as much as possible. Once it occurs, active symptomatic treatment should be taken to avoid aggravating the condition. Tonsillectomy is recommended if the disease is often induced or aggravated by tonsil suppuration. (For this tonsil removal, you should be cautious.)

    3. Eliminate mental stress factors, avoid excessive fatigue, and pay attention to rest.

    4. The living conditions should be dry, ventilated and convenient for bathing.

    5. In daily medication, antimalarial drugs and β-blockers can induce or aggravate the condition.

    6. Endocrine changes and pregnancy can induce and aggravate the disease

    7. Eat more foods rich in vitamins, such as fresh fruits and vegetables.

    8. When cleaning the affected area, you should rub it gently and don't forcefully peel off the dander, so as to avoid local infection, such as redness, swelling, heat, and pain, which will affect the treatment and prolong the course of the disease.

    The eight important points of perianal eczema care are just above. In addition to these, there is postoperative mental health care. There may be many patients with perianal eczema who relapse after cure. Patients often worry that the disease will relapse. At this time, the doctor must give Enlighten, as long as the patient pays attention to personal hygiene and eating habits, the disease will not recur.

hemorrhoids essential oils,Diagnosis and treatment of mixed hemorrhoids

    Mixed hemorrhoids occur on the same tooth line up and down, forming a unified mass of varicose veins.

    Diagnosis points

    1. Hematochezia and anal swelling, there may be anal swelling, foreign body sensation or pain.

    2. May be accompanied by local secretions or itching.

    3. There is a swelling in the same position above and below the tooth line (the epidermis may also be under the tooth line).

    Differential diagnosis

    1. Anorectal prolapse, 2. Rectal cancer, 3. Low rectal polyps, 4. Anal papillary fibroids, 5. Anal condyloma acuminatum, 6. Inflammatory bowel disease

    an examination

    1. Required items: inspection, digital diagnosis, anoscope, etc.

    2. Items for reference: anorectal pressure measurement, pathology, etc.

    deal with

    (1) Traditional Chinese Medicine:

    1. Internal governance

    If the syndrome is wind-injured intestinal collaterals, the treatment is to clear heat and cool blood, dispel wind and stop bleeding. Fang chooses Liangxue Dihuang Decoction or Huaijiao Pills.

    If the card is damp-heat betting, the treatment is to clear heat and eliminate dampness. Fang chooses pain-relieving Rushen Tang, Zanglian Pill, or Sanmiao Pill and Huaijiao Pill.

    If the syndrome is qi stagnation and blood stasis, the treatment is to promote qi, promote blood circulation and remove blood stasis, reduce swelling and stop bleeding. Fang chooses Honghua Taoren Decoction or Xuefu Zhuyu Decoction.

    If the syndrome is spleen deficiency and qi depression, the treatment is to invigorate the spleen, invigorate the qi and raise the qi. Fang choose Huangtu Tang or Buzhong Yiqi Tang or Guipi Pills.

    2. External treatment

    (1) Fumigation and washing: fumigation and washing with Chinese medicine decoction for external hemorrhoids.

    (2) Suppository medicine: hemorrhoid ointment or hemorrhoid embolization of the anus, 2 times a day.

    (3) Medication: External hemorrhoids can be treated with general Xiaozhong San Tiaohuanglian ointment for external hemorrhoids, partial swelling, pain, and incarcerated hemorrhoids, and Kuzhisan can be used for external application when conditions permit.

    (2) Western medicine:

    Treatment principle: hemostasis, anti-inflammatory, eliminate prolapse. Its purpose is: 1. Control bleeding symptoms; 2. Eliminate inflammation, reduce or eliminate swelling and pain; eliminate symptoms of prolapse.

    Specific treatment:

    1. Medicine: Xiaotuozhi 4 tablets, 3 times a day.

    When internal hemorrhoids are incarcerated, inflammatory external hemorrhoids, and thrombotic external hemorrhoids, sensitive antibiotics can be used orally, and sensitive antibiotics can be injected intramuscularly or intravenously if necessary.

    2. Injection: The internal hemorrhoids of mixed hemorrhoids can be treated with "603 Xiaozhiye" injection, and "Xiaozhiling" hardened injection. Varicose external hemorrhoids can be treated with "603 Xiaozhiye" as "four-point injection of external muscle".

    3. Surgical treatment: suitable for prolapsed internal hemorrhoids, large external hemorrhoids, frequent swelling and pain or obvious swelling and pain. Commonly used surgical procedures such as external stripping and internal ligation of mixed hemorrhoids.

    4. Other treatments

    The internal hemorrhoids of mixed hemorrhoids can be treated with anal expansion therapy, hemorrhoid treatment machine, microwave cauterization, and infrared coagulation therapy. These therapies are mainly used for patients with internal hemorrhoids in the first or second stage. Laser can be used for external hemorrhoid resection and PPH treatment of prolapsed third and fourth stage circular internal hemorrhoids.

what does a hemorrhoids look like,Essential knowledge for anorectal surgeons

    Julu Painless Anorectal——Because of professionalism, excellence

    Essential knowledge for anorectal surgeons

    One: Anorectal Anatomy:

    Rectum: The upper part is connected to the sigmoid colon and the lower part is connected to the anal canal, with a total length of 12-15 cm, rectal and bladder lacuna, females are rectal-uterine lacuna;

    Rectal column: there are about 10 where the lower end of the rectum connects with the anal canal;

    Anal flap: a half-moon-shaped wrinkle pocket between adjacent rectal columns;

    Anal sinus (anal recess): the funnel-shaped gap between the anal valve and the rectal wall, opening upward;

    Tooth line: the anal flap and the base of the rectal column, forming an irregular jagged edge at the junction of the rectum and anal canal; the comparison of the anatomical line up and down

    Tissue blood supply innervation lymphatic drainage

    Dental line Mucosa Arteries: superior and inferior rectal arteries Autonomic nerves adjacent to the abdominal aorta

    Veins: superior rectal venous plexus-portal vein no pain or internal iliac artery

    Under the tooth line Skin Arteries: Anal artery Internal pudendal nerve Inguinal lymph

    Veins: Inferior rectal vein-vena cava, acute pain, periiliac lymph

    Anal canal: 3 cm long, the upper edge is the tooth line, and the lower edge is the anal edge;

    Anal stents: involuntary muscles, innervated by autonomic nerves;

    Extra-anal stents: divided into subcutaneous, superficial, deep, voluntary muscles; cutting off the subcutaneous stents of the external stents will not cause fecal incontinence, and cut off the anorectal which is composed of the deep, puborectalis and internal stents Ring, causing fecal incontinence;

    Two: Anorectal examination method:

    1. Position: According to the patient's physical condition and specific requirements.

    Knee-thoracic position: This position makes the anal canal droop, the anal area is clearly exposed, the internal organs are moved up, and the pelvic cavity is empty. The inspection is convenient and easy to succeed. It is the most commonly used position;

    Left prone position: This position is suitable for people who are weak or who are doing simple treatment at the same time;

    Lithotomy position: Clearly exposed and can be used for double diagnosis at the same time. This position is also a common position for rectal anal surgery; squatting position: It is suitable for checking internal hemorrhoids, prolapsed anus or rectal polyps, etc. This position has the greatest pressure on the rectum and anal canal and internal hemorrhoids can be seen And the most serious cases of prolapse;

    Bent arm chair position: poor exposure, but convenient and time-saving, suitable for population health survey;

    2. Inspection: presence of blood, pus, feces, mucus, fistula, lumps, eczema, ulcers, scars, anal tightness or relaxation, external hemorrhoids, prolapsed internal hemorrhoids or rectal mucosa, pinworms, anus Sentinel hemorrhoids, sentinel hemorrhoids, let the patient apply force toward the anus to observe for internal hemorrhoids, polyps or anorectal prolapse, etc.;

    3. Digital rectal examination: simple but extremely important;

    4. Anoscopy: enter the anus first, then exit slowly, observe, record according to the clock, and do not miss a comprehensive observation;

    Check the contraindications: anal stenosis, women's menstrual period, anal fissure or local inflammation and pain;

    5. Sigmoidoscopy: It is an important examination method for the diagnosis of upper rectum and lower sigmoid colon lesions. For: unexplained blood in the stool, mucus stool, chronic diarrhea, tenesmus, thin stools and other clinical manifestations, sigmoidoscopy should be considered;

    Methods: The day before the examination, give a no-dregs diet and laxatives, and an enema before the operation. The first digital anus examination, the lens is about 15 cm, the intestinal cavity becomes smaller and there are spiral mucosal folds, which is the sigmoid colon. Biopsy can be taken at the same time, but do not take the center of the ulcer or the ulcerated part of the tumor to avoid perforation.

    Complications: bleeding, perforation;

    6. X-ray barium enema examination: filling defect or mucosal destruction;

    7. Defecation examination: suitable for long-term constipation, a method to determine the morphology, function and dynamics of the anal sphincter and anorectal;

    8. CT examination: understand the location and size of the tumor, provide the relationship between the tumor and the surrounding pelvic organs and the scope of tumor invasion, and perform the staging of rectal cancer;

    9. MRI: Perform rectal examination before or after surgery;

    10. Intrarectal ultrasound scan: preoperative staging and postoperative review of rectal cancer;

    Three: hemorrhoids

    Definition: The soft venous mass formed by the varicose plexus at the lower rectum and anal margin, which is more common in 20-40 years old;

    (1) Cause:

    1. Anatomical factors: The rectal anal canal is located in the lower part of the trunk, the portal vein system has no venous valve, and the pressure of the venous plexus in the hemorrhoid increases;

    2. Increased intra-abdominal pressure: pregnancy, dysuria, constipation, etc.;

    3. Chronic infection of lower rectum and anal canal:

    4. Birth defects or trauma:

    (2) Clinical manifestations:

    Internal hemorrhoids, external hemorrhoids, mixed hemorrhoids;

    1. Bleeding: not mixed with stool, or dripping blood during defecation;

    2. Prolapse: mostly in a circle;

    3. Pain: Pain is obvious during infection, erosion, thrombosis or incarceration;

    4. Itching: combined with eczema;

    Internal hemorrhoids: varicose plexus of the superior rectum;

    Stage I: Bleeding during defecation, no pain, no prolapse, it usually occurs on the left side, right front and right back of the anal canal;

    Stage II: Prolapse when defecation is exerted, and can repay by itself, with obvious blood in stool

    Stage III: Defecation, coughing, straining, walking, squatting can be released, cannot repay by oneself, must be backed with hands, easy to incarcerate necrosis;

    Stage IV: Internal hemorrhoids continue to prolapse and cannot be repaid. The hemorrhoids are covered with skin, which usually occurs in the elderly;

    External hemorrhoids: located below the dental line, formed by the varicose vein plexus under the hemorrhoids, covered with skin on the surface and cannot be pushed into the rectum; thrombotic external hemorrhoids are prone to form, with external hemorrhoid skin tags;

    Mixed hemorrhoids:

    Diagnosis and differential diagnosis: diagnosis is not difficult;

    Differential diagnosis:

    Rectal cancer:

    Rectal adenoma: painless blood in the stool, pedicle, smooth surface;

    Prolapse of the rectal anal canal: can reach the annular wrinkle wall of the rectal mucosa;

    Anal fissure: often bleeding during defecation, severe pain during and after defecation;

    Anal papillary hypertrophy: Accompanied by chronic anal sinusitis, pain during defecation, and hardened hypertrophic nipples can be touched on digital examination;

    Treatment: Hemorrhoids in stage I: moisturize the intestines to lax, avoid sitting for a long time, defecate regularly, sit in hot water;

    Stage II hemorrhoids: local injection of sclerosing agent, causing periphlebitis: 5-10% phenol, vegetable oil, 5% sodium morrhuate;

    Stage III: Resection, lateral incision of the internal sphincter;

    Anal fissure: It is actually an anal canal ulcer. It is divided into acute and chronic. The stent muscles at the midline of the anal canal are weaker than the two sides. After the anal fissure is formed, it will cause secondary infection due to fecal friction The stent muscles contract spasm and contract, causing ischemia and forming chronic ulcers. The skin at the lower end of the ulcers forms skin tags due to long-term inflammatory stimulation, edema and proliferation, called sentinel hemorrhoids (sentinel hemorrhoids).

    One: Clinical manifestations: Pain: severe pain during defecation, unbearable, pain after defecation lasts for several hours, a vicious circle;

    Bleeding: small amount;

    constipation:

    Inspection: Prohibit digital rectal examination, or anoscopy, and lightly expose the anal canal;

    Two: Treatment: Conservative treatment: suitable for acute anal fissures, focusing on preventing and treating constipation, softening feces to relieve pain, hot bath;

    Anal expansion: Acute and chronic anal fissures, especially acute anal fissures are effective;

    Method: After anesthesia, expand the anus with the fingers to paralyze the internal and external sphincter for several days to one week to relieve pain and improve local blood circulation. The anal expansion should be relaxed. Start with 2 fingers, expand to 4-6 fingers, stretch 5-10 minute;

    Surgical resection: internal sphincterotomy, surgical complication is fecal incontinence

    Anal fistula:

    One: Definition: A chronic infectious fistula between the anal canal or rectum and the skin.

    Two: Classification: ①High anal fistula: The location of the fistula is above the deep part of the external sphincter;

    ②Low anal fistula: ------------ down;

    ③Simple anal fistula: an external mouth;

    ④Complex anal fistula: multiple external openings;

    Three: Clinical manifestations: There is a history of incision and drainage of perianal abscess, secretion flows out, and a hard cord between the external mouth and the anus can be felt on the digital rectal examination;

    Four: treatment

    Rarely heals on its own

    Anal fistula incision and resection: Correctly handle the internal opening. Only when the internal opening is cut or resected can the anal fistula be cured. All branch tubes should be opened one by one without missing. Surgery generally only cuts all the internal sphincter muscles and most of the external sphincter muscles, and generally does not cause fecal incontinence;

    Thread-hanging therapy: suitable for high anal fistula, which can avoid anal incontinence;

    Colorectal cancer:

    1. The incidence rate ranks fourth and fifth in the incidence of malignant tumors in China, accounting for 8.25%. In the past ten years, the incidence rate has increased; the age of onset is mostly 30-70 years old, accounting for 80%, and patients under 30 years old account for 10 -15%, male: female = 1.5 to 2.0:1; in all colorectal cancers, rectal and rectal-b junction cancers account for 60 to 70%, followed by sigmoid colon, cecum, ascending colon, descending colon, and transverse colon. Rectal cancer is more common in the middle and lower rectum, accounting for about 70-80%. Multiple cancers are more common, accounting for about 5-8%, and can appear in different parts at the same time or successively; 2: Causes

    1. Dietary factors: high-fat, low-fiber diet, increase the intestinal bile acid and cholesterol metabolites, increase anaerobic bacteria in stool, increase carcinogenic factors; lack of fiber in food, reduce stool volume, and intestinal movement Slowing down, so that the concentration of carcinogens in the intestine increases, the contact time of carcinogens with the colorectal mucosa is prolonged, and the chance of colorectal cancer is increased;

    2. Strong genetic tendency:

    A: Familial multiple adenomatosis is an autosomal dominant genetic disease, involving all the large intestine and even the entire digestive tract. If it is not treated, 100% of it will become malignant;

    In patients with colorectal cancer, 50% have two or more cancer foci.

    Gardner's syndrome: familial multiple adenomatosis with multiple skin epidermoid cysts and soft tissue tumors, skull and mandibular multiple osteomas, is called "Gardner's syndrome";

    Turcot's syndrome: patients with central nervous system malignant tumors;

    B: Cancer family syndrome (cancer family syndrome): It is an autosomal dominant inherited disease, with a penetrance rate of 90% (that is, 90% of children can be affected); cancers have an earlier age of onset, often multiple colorectal cancers; Such patients are also more likely to suffer from endometrial cancer, ovarian cancer and other organ cancers;

    C: Family members of colorectal cancer patients die from colorectal cancer 4 times higher than the average person;

    D: Inflammatory colorectal disease: The chance of colorectal cancer in patients with ulcerative colitis is 5-10 times higher than that of normal people. The longer the disease period, the larger the lesion area, the higher the risk of canceration, and the incidence of Crohn's disease and schistosomiasis enteritis. The chance of colorectal cancer is also greater than that of normal people;

    E: Colorectal adenoma: The risk of cancer in such patients increases. The larger the polyps, the greater the number, the worse the epithelial differentiation, and the higher the chance of cancer.

    In terms of pathological classification, the malignant transformation rate of villous adenoma is as high as 40%, and the chances of mixed and tubular adenomas are 20% and 5% respectively;

    F: Other related factors: people who have had colorectal cancer in the past, have received radiotherapy in the pelvis, have been exposed to synthetic fibers, dyes, and rubber for a long time, and lack of certain trace elements (such as molybdenum, selenium, etc.);

    Three: diagnosis

    Take a comprehensive medical history; different tumor sites have different symptoms:

    A: Right colon: usually umbrella or ulcer type, protruding intestinal cavity, often accompanied by abdominal masses, anemia, intermittent melanosis, weakness, weight loss, etc.;

    B: Left colon: Cancer often grows infiltratingly, which is easy to cause ring-shaped stenosis, often causing abdominal pain, difficulty in stool, pus and blood in the stool, and intestinal obstruction;

    C: Rectal cancer: often manifested as changes in bowel habits, pus and blood in the stool, tenesmus, anal pain, such as tumor invasion of the sacral plexus nerve, often severe pain in the sacral coccyx. In the late stage, the bladder may be involved, penetrate the vaginal wall, and form a rectal-vaginal fistula; in the late stage, inguinal lymph nodes may metastasize;

    Common diagnostic methods:

    A: Rectal examination: 70% of rectal cancer can be found through digital rectal examination;

    B: Fecal occult blood test: About 50% of stool occult blood positive is caused by colorectal cancer, occult blood test should be repeated 3 times;

    C: Barium enema and sigmoidoscopy: suspicious patients over 40 years of age should be routinely examined, and fiber colonoscopy should be performed if necessary. If rectal cancer has been diagnosed by digital rectal examination and rectal endoscopy, full colonoscopy is still required. To exclude whether there are cancer foci at the same time in the proximal colon;

    D: To determine the extent of disease and metastasis, a comprehensive examination of colorectal cancer patients should include: chest X-ray, liver function, liver ultrasound, abdominal CT, CEA measurement, intrarectal ultrasound scan, IVP (for patients with low cancer or urinary system symptoms) );

    Four: Pathology and transfer methods

    The general classification of colorectal cancer: protruding type, ulcer type, infiltrating type, proofing type.

    Histological classification: papillary adenocarcinoma, tubular adenocarcinoma, mucinous adenocarcinoma.

    Degree of differentiation: low-grade malignancy (highly differentiated), moderately malignant (moderately differentiated), and high-grade malignant (poorly differentiated);

    Duke's staging: established in 1935, according to the depth of tumor invasion and the presence or absence of lymph node metastasis,

    Stage A: Cancer is confined to the intestinal wall;

    Stage B: Cancer penetrates the intestinal wall;

    Stage C: The lymph nodes have metastasized;

    Stage C1: The cancer has metastasized to adjacent lymph nodes;

    Stage C2: Metastasis of mesenteric lymph nodes or root lymph nodes of mesenteric vessels;

    Stage D: distant transfer;

    China proposed the clinicopathological staging of colorectal cancer in 1978:

    Stage I: (equivalent to Dukes stage A), the cancer is confined to the intestinal wall, and is divided into three sub-stages

    Stage Ⅰ0: The lesion is limited to the mucosal layer;

    Stage Ⅰ: The lesion invades the submucosa;

    Stage I2: The disease involves the muscular layer of the intestinal wall but does not penetrate the intestinal wall;

    Stage II: The lesion has penetrated the intestinal wall without lymph node metastasis;

    Stage III: The cancer has penetrated the intestinal wall and has lymph node metastasis;

    Stage III1: Lymph node metastasis is limited to the vicinity of the cancer;

    Stage Ⅲ2: Mesangial lymph nodes, lymph node metastasis at the root of mesangial vessels;

    Stage IV: Patients who cannot be resected or cannot be completely resected due to extensive infiltration of the lesion, distant metastasis or planting and dissemination; Five: Prognosis of colorectal cancer, the 5-year survival rate is 30-40%, the best prognosis among common malignant tumors, colon cancer Better than rectal cancer; radical resection, the 5-year survival rate can reach 55-70%, some stage IV cases can still be treated with palliative resection, the survival time can be prolonged, and the quality of life can be improved; the primary tumor is still early, there is For single or several liver or lung metastases, radical resection of the primary tumor can be performed, followed by local or extensive resection of the metastasis; factors affecting the prognosis of colorectal cancer: disease course, tumor location, disease stage, treatment level, immune status;

    Six: Direct infiltration of colorectal cancer metastasis: implantation and dissemination: lymphatic metastasis: hematogenous metastasis: It is an important dissemination route of colorectal cancer, often invading veins, with a chance of up to 20-30%, especially for rectal cancer;

    Seven: Treatment Surgical treatment is the main method: according to different parts of the tumor, different surgical methods are selected; preoperative bowel preparation: oral antibiotics that are not absorbed by the intestine, clean enema;

    Surgical options: Ⅰ: Cecum and ascending colon cancer: Resection of the right colon, including 10-15 cm of the terminal ileum;

    Ⅱ: Liver flexure, splenic flexure and transverse colon: Resection of transverse colon, part of ascending colon, part of descending colon;

    Ⅲ: Cancer of descending colon and sigmoid colon: Resection from splenic flexure to sigmoid colon, proximal rectum and its mesangium and lymph nodes;

    Ⅳ: rectum: less than 7 cm, Miles

    7-10 cm, Dixon

    Higher than 10 cm, front excision;

    Ⅴ: Colon cancer with intestinal obstruction: The right colon is currently resected and anastomosed in one stage;

    Left colon-there is controversy;

    Upper middle part of rectum-Hartman operation;

    Adjuvant treatment:

    Ⅰ: Chemotherapy: Patients with advanced tumors, recurrence and metastasis after surgery should all be treated with chemotherapy, usually 5-fu, FT207, UFT, mitomycin, etc. Combination chemotherapy is better. There is no definite conclusion about postoperative chemotherapy for colorectal cancer, but for patients with lymph node metastasis, postoperative chemotherapy may be beneficial;

    Ⅱ: Radiotherapy: Preoperative radiotherapy can shrink rectal cancer and reduce the rate of local recurrence; postoperative radiotherapy can reduce or delay local recurrence. Radiotherapy can also relieve presacral pain, but it has no obvious pain relief effect on colon cancer;

    Eight: Postoperative recurrence and metastasis 40-70% of patients after radical resection have local recurrence and distant metastasis. The biological behavior of colorectal cancer is relatively good. With the progress of surgery, radiation, and drugs, some recurrence and metastasis Long-term survival can still be achieved for most patients, and the survival time of most patients is prolonged; 70% of colorectal cancer recurrence cases occurred within 2 years after surgery, and 6% recurrences over 5 years. 80-90% of patients with local recurrence died within 3 years; local recurrence is the recurrence in the original surgical field, including: recurrence of anastomotic, pelvic, perineal and abdominal wall incisions. The most visceral metastasis is liver, followed by lung and bone. , Ovary, brain; the role of CEA: treatment of patients with recurrence and metastasis: Studies have shown that 20% of patients who recurred after rectal cancer death until death are limited to local recurrence. If early diagnosis and active treatment can be achieved, better The effect of treatment; 40% of patients can survive for 5 years after resection of isolated liver metastases;

    Nine: The progress of rectal cancer is total mesangial resection; the 5 cm rule is abolished and the 3 cm rule is abolished; 3000 cases of rectal cancer resection specimens study: only 2.3% of patients with lymphatic metastasis at 1 to 2 cm distal to the lesion. The rectum can be elongated by 3 to 5 cm after bilateral lateral ligament cut; application of stapler; new surgical method: Parks: transabdominal resection of rectum, colon-anal anastomosis via anal canal; Oskar: free transabdominal cut, distal Resection through the anus, and the proximal end is pulled out for anastomosis; Shafik: free through the abdomen, circular incision at the edge of the anal crease, dissecting the lower edge of the internal and external sphincter muscles, separating upwards between the internal and external sphincter until the abdominal and pelvic separation junction Resection of the end colon and suture with the perianal skin; middle and low rectal cancer anus preservation surgery: 26% in the 1950s, 93% in the 1980s, common complications of anus preservation surgery: intestinal necrosis, leakage, stenosis, obstruction, bowel retraction , Infection; 150 domestic stapling anus preservation operations: the 1-4 year survival rates are 94%, 84%, 76%, and 63%, which are similar to the Miles operation of the same disease stage;

    Ten: Auxiliary examination for recurrence: 65% of recurrence is within 2 years, follow-up for at least two years; regular CEA; pelvic X plain film, sometimes visible soft tissue shadows; pelvic B-ultrasound; CT examination: can show 1 cm in diameter;

hemorrhoids treatment otc,Minimally invasive surgery pph surgery

    PPH is the abbreviation of procedure for prolapse and hemorrhoids in English, and Chinese means "operation for hemorrhoids and rectal mucosal prolapse". It uses a special hemorrhoidectomy stapler to circularly remove the hemorrhoids and submucosa tissues, and at the same time anastomose the distal and proximal mucosa to treat internal hemorrhoids. Therefore, it is interpreted in China as "circumferential resection of stapled hemorrhoids" or "circular resection of stapled hemorrhoids."

    Apparatus has been applied to anastomose tissues and organs for nearly 100 years. In 1908, the Hungarians Hultl and Fischer first used the suture device for gastrectomy. The stapler is suitable for end-to-end, end-to-side and side-to-side anastomosis in various operations such as esophagus, stomach, duodenum, small intestine, colon, rectum, and biliary tract.

    In 1997, Pescatori et al. reported that transanal stapler rectal mucosal resection was used to treat rectal mucosal prolapse.  Professor Longo from Palermo University in Italy first proposed PPH at the Rome World Congress in 1997, and formally wrote a report in 1998. The earliest development in Asia was Professor Xiao Jun from Singapore Hospital in 1999. The first domestic case was completed by Shanghai Yao Qingli in July 2000.

    principle

    The theoretical basis of PPH is Thomson's "anal cushion theory" in 1975 and Londer's "anal cushion theory" in 1994.  Anal cushion theory first believed that mild bulging of the lower rectal mucosa is present in everyone, not a hemorrhoid, but a physiological cushion that assists the anus to close. The anal cushion theory believes that this type of cushion is hypertrophic and shifts downward to be hemorrhoids.

    The PPH method is to circularly excise the mucosa and submucosal tissues of the intestinal wall above the tooth line, and perform an anastomosis of the distal and proximal mucosa. On the one hand, the rectal mucosa with a width of 3 cm can be removed, and at the same time, the rectal anal canal tissue that moves downward can be suspended and pulled upward. On the other hand, due to the stimulation of the foreign body of the staple, the rectal mucosal tissue produces an inflammatory reaction, and the surrounding tissues of the rectum are scarred and fixed so that it no longer prolapses. It can tighten and fix the anterior wall of the rectum and reduce the degree of rectal protrusion. So the treatment principle of PPH can be summarized as:

    Suspension: circular excision of the mucosa and submucosal tissues of the intestinal wall at the lower end of the rectum, so that the prolapsed anal cushion is suspended and pulled upwards. Restores the local anatomical relationship between the anal mucosa and the anal sphincter, and eliminates the basis of prolapsed hemorrhoids. Wood symptoms.

    Devascularization: As the arteries supplying hemorrhoids in the submucosa are cut off at the same time, the blood supply of hemorrhoids decreases after the operation, and the hemorrhoids gradually atrophy about 2 weeks after the operation, which can reduce the impact of the traumatic backlog caused by the fecal mass on the mucosa. The main cause of hemorrhoid bleeding.

    Indications

    At present, it is generally believed that the main indication for PPH is II-IV degree internal hemorrhoids, that is, internal hemorrhoids with repeated prolapse. Jongen believes: "The most ideal indication is II and III degree hemorrhoids." Ren Donglin, a domestic scholar, believes that the ideal indication is third-degree hemorrhoids without anal skin tags. A domestic academic organization established the indications for PPH in 2005 as: 1. Ring-shaped prolapsed grade III and IV internal hemorrhoids, mixed hemorrhoids; 2. Prerectal bulge and internal rectal prolapse that cause functional outlet obstruction constipation .

    advantage

    1. It can better preserve the anal canal mucosal layer and anal cushion anatomical structure, restore the self-made defecation function of the anus, coordinate the activities of the internal and external sphincter muscles, reduce the pressure in the anal canal, and avoid postoperative anal stenosis, anal incontinence, fine bowel control and other complications The occurrence of disease.

    2. Resection and anastomosis of the rectal mucosa and submucosa are located in the 2 cm area of ​​the dentinal line. There are very few sensory nerves. At the same time, it avoids surgical damage to the anal canal skin and mucosal layer, which can significantly reduce postoperative anal pain and discomfort. The patient is basically uncomfortable.

    complication

    A multi-center report of 1100 cases in Germany in 2000: The total complications (excluding long-term) were 9.8%, including postoperative bleeding, pain, urinary retention, thrombotic external hemorrhoids and so on. Retrieving 69 relevant reports included in the domestic Chinese database from 2000 to 2003, the occurrence of complications was as follows: 10.0% to 10.7% of patients had anal pain, 11% to 15% had urinary retention, and 10.0% to 11.5% had hematochezia.

hemorrhoids and anal fissures,Precautions after anal surgery

    Correct care after anal surgery plays a vital role in wound healing and reducing complications. Some operations are very successful, but improper postoperative care can lead to complications such as wound edema, infection, prolapse, poor drainage, slow healing, and false healing. In order for the patients to recover smoothly, we will explain the precautions for common anal operations such as hemorrhoids, anal fistulas, anal fissures, and perianal abscesses.

    1. Diet and exercise, defecation

    Surgery day: Patients with local anesthesia can eat normally, patients with spinal anesthesia can eat after 6 hours of lying supine, and patients with general anesthesia can eat after fully awake. Eat porridge, noodles, egg drop and other semi-liquid diet. Don't eat fat, greasy, spicy food, don't eat cold foods such as fruits, and don't drink honey and beverages to avoid flatulence and diarrhea. Bed rest is the main operation day.

    The first day after the operation: eat a semi-liquid diet, take a proper walk, control bowel movements, fumigate the anus with Chinese medicine and change the dressing.

    The second day after the operation: normal light diet, eat more crude fiber food, drink plenty of water, walk appropriately, control bowel movements, fumigate the anus with Chinese medicine and change the dressing. Oral intestines and laxatives at night, such as polyethylene glycol 4000 powder, hemp capsules, etc. help defecation.

    3-20 days after surgery: You can defecate, clean the anus after defecation, change the dressing after fumigation and washing with Chinese medicine. The diet is based on light, crude fiber foods, nutritious and easily digestible foods, such as chicken soup, fish soup, lean meat, fish, duck, etc. Proper walks, do not bear weight (such as carrying water, mopping the floor, etc.), do not have sex, do not sit for a long time and squat.

    Avoid alcohol and spicy food for 3 months after the operation, do not do strenuous exercise, do not ride a bicycle, and do not do heavy physical work.

    The water temperature is appropriate during the fumigation and the time should be controlled. Patients with perianal abscess, anal fistula, and anal fissure can sit in a bath for 10 minutes, and patients with hemorrhoids can take 2 minutes. Squatting and sitting for a long time can cause wound edema.

    Stools are difficult to pass, do not work hard, tell the doctor to deal with it, you can open the syrup or clean the enema.

    2. Pain

    The development of minimally invasive surgery and the construction of painless wards have significantly reduced postoperative pain. However, some patients are still suffering from severe illness and still have slight pain after surgery. Pain can be relieved by oral or intramuscular injection of analgesics. Slight pain in the anus during defecation is normal, and it can be relieved by timely washing and fumigation after defecation.

    Three, bleeding

    It is normal for the anal dressing to have a little bleeding within 24 hours after the operation. If the dressing is completely soaked or bleeding is heavy, please tell the doctor in time.

    A small amount of blood dripping or blood on the toilet paper is normal when you have stool. If the blood flow does not stop or a large number of blood clots are discharged, tell the doctor immediately.

    Patients undergoing hemorrhoid surgery should pay attention that 5-14 days after the operation is the hemorrhoid shedding period, do not dry and clump the stool, have a moderate amount of activity, and a small part of the hemorrhage is heavy, so you need to tell the doctor in time.

    Four, anal bulge

    On the day of surgery, most patients will have a feeling of bulging in the anus. If the urination is not smooth, the feeling of bulging will be even worse.

    Anal swelling is related to surgical stimulation, oil gauze packing, and urinary discharge. It will be significantly reduced after more than ten hours after surgery.

    Five, secretions

    There is a small amount of secretions in the anus after the operation, so the patient should not worry that the wound is purulent. Anal fistulas and abscesses have a lot of secretions in the first week, and then gradually decrease, which will last about 25-40 days. If accompanied by anal swelling, pain, fever, and chills, consider the possibility of wound infection.

    6. Wound edema

    Loose tissues around the anus, frequent squatting on the toilet after surgery, difficulty in urination, premature defecation, frequent defecation, all of which can easily lead to wound edema. Don’t worry too much if edema occurs. Correct the above factors and after treatment by a doctor, it will gradually decrease and disappear.

hemorrhoids specialist,Varicose Hemorrhoids

    Varicose external hemorrhoids are soft masses formed on the anal rim due to blood stasis and varicose in the external hemorrhoid plexus. They are mostly found in the anal canal or subcutaneously on the left middle, right front, and right back of the anus. The bumps are oval or ring-shaped. It is irregular in shape and soft in texture. The swelling gradually enlarges when struggling hard during defecation, and it is blue-purple, and gradually shrinks after defecation. Generally, there is no pain, or there is only a feeling of foreign body falling. This disease often coexists with hemorrhoids in the second and third stages.

    Cause

    It is mostly because of repeated prolapse of hemorrhoids in the second and third phases, or increased abdominal pressure after pregnancy by the parturient, which results in the obstruction of superficial vein and subcutaneous lymphatic drainage, causing the expansion and varicose of the external hemorrhoidal venous plexus below the anal canal tooth line.

    Clinical manifestations

    The onset is slow. At first, I only feel discomfort when the anus is swollen, but usually does not show up. When the abdominal pressure is increased by defecation and squatting, there are irregular or oval lumps on the anal margin, covered with skin and dark purple. After going to the toilet, squatting for a long time, or when internal hemorrhoids are attracted, there is a feeling of anal bulge or foreign body, which can not disappear immediately. Generally, there is no pain, no bleeding, and internal hemorrhoids. If there is inflammation, symptoms such as anal swelling and pain will appear

    an examination

    Physical examination: It can be seen that there are round, oval or long lumps on the skin of the anal margin. The surface is blue-purple and shiny. When squatting for a long time or attracting internal hemorrhoids, the lumps enlarge, and varicose veins can be seen.

    diagnosis

    1. Have long-term constipation or squatting in the toilet for too long before the onset.

    2. Internal hemorrhoids can coexist at the same time.

    3. Generally, there is no conscious symptom. Only when the bowel movement is too long, the anus will feel swollen with a foreign body, the swelling is obvious, and it will gradually shrink after the bowel movement.

    4. There are irregular or oval lumps on the anal margin, covered with skin, dark purple, generally painless and no bleeding.

    Differential diagnosis

    1. Thrombotic external hemorrhoids

    The swelling occurred suddenly, the pain was severe, the color was dark purple, the tenderness was hard, and the ulceration showed congestion and overflow.

    2. Anorectal abscess

    Perianal swelling and pain, obvious tenderness, fluctuating sensation during pus formation, ulceration and discharge.

    3. Connective tissue external hemorrhoids

    The skin tag gradually increased, the anus and abdominal pressure increased, and the hemorrhoids remained unchanged and no tenderness.

    treatment

    Treatment is not necessary for milder ones, and for heavier ones, the bowel movement should be kept unobstructed. Astringent ointment is applied locally to relieve symptoms. After non-surgical treatment fails, varicose external hemorrhoids can be treated with dissection. Method of operation. The patient lies in the lithotomy position or on his side, routinely disinfected, injected 0.75% lidocaine, local anesthesia, lifted the external hemorrhoids with mosquito forceps, made a radial fusiform incision around the root of the hemorrhoid with surgical scissors, and sharply separated the subcutaneous varicose The venous plexus to the anal margin is removed together with the skin and subcutaneous tissue. After the operation, the wound is covered with petroleum jelly gauze and pressure-wrapped; control bowel movement for 1 to 2 days, after the defecation, use 0.2g/L potassium permanganate to sit in a bath, wipe dry, and apply oil gauze until healed.

    Department of Anorectal, Tongchuan District Hospital of Traditional Chinese Medicine, Dazhou City

hemorrhoids and anal fissures,Clinical analysis of 1918 cases of mixed hemorrhoids treated by external stripping and internal ligation

    Abstract Objective: To observe the clinical effect of mixed hemorrhoids external stripping and internal ligation plus Xiaozhiling injection instead of partial hemorrhoidectomy (restrictive hemorrhoidectomy). Method: Retrospectively summarize the clinical data of 1918 cases of mixed hemorrhoids treated by this method. Results: The clinical cure rate was 100%, the average hemorrhoid shedding time was 9.5 days, and the wound healing time was 25 days. There was no obvious anal stenosis affecting defecation function in all cases. Conclusion: The operation is simple and effective. Xiaozhiling sclerosis injection is used to replace part of hemorrhoid area resection, plus correct and reasonable anal expansion before operation and necessary internal sphincterotomy for some patients after operation to reduce postoperative Complications such as bleeding, pain, anal edema and anal stenosis.

    Guan Jian's words Mixed hemorrhoids External peeling and internal ligation

    External stripping and internal ligation of mixed hemorrhoids is a classic procedure for the treatment of mixed hemorrhoids. The author makes a retrospective summary of the data of hospitalized patients since 1986 for 20 years.

    1. clinical information

    This group of 1918 patients (patients hospitalized from 1986 to 2005), 910 males, 1008 females, aged 17-82 years old, 35-65 years old accounted for 86.23%, the course of the disease was 5-60 years, and the clinical symptoms were such that blood and hemorrhoids were prolapsed. the Lord. Among them, there were 328 cases of circular mixed hemorrhoids, 98 cases of incarceration, 135 cases of anal fissures, 69 cases of nipple hypertrophy, 15 cases of polyps, and 32 cases of pregnant patients. The diagnosis met the standards established by the National Anorectal Academic Conference in 1975 [1].

    2. method

    Adopt mixed hemorrhoids external stripping and internal ligation, do not clean the enema before the operation, lying on the left side, disinfect conventional drapes, use 20ml of compound anesthesia (0.75% bupivacaine 5ml, 2% lidocaine 5ml, 0.9% chlorine Sodium 10ml) for perianal local anesthesia at 3 and 9 o'clock, slowly expand the anus to the four fingers, clamp the base of the internal hemorrhoids with a large curved vascular clamp, and use a No. 7 double-stranded wire to penetrate above the internal hemorrhoids first Tie a knot, use tissue forceps to lift the external hemorrhoid skin to make a V-shaped incision, separate the external hemorrhoid tissue along the base, purely free the skin, gather the wound inward under the dent line to make the wound surface above the dent line and then ligate the base Cut off the hemorrhoid stump 0.5cm from the ligation line, and put a Vaseline gauze on the wound. The ring-shaped mixed hemorrhoids are ligated in segments according to the natural depression of the hemorrhoid mucosa. The ligation points are staggered up and down to avoid being on the same level, and the mucosal skin bridge of each ligation area is more than 0.5cm. For hemorrhoids or smaller hemorrhoids that are not serious and cause no symptoms, Xiaozhiling injection should be properly administered. For circular mixed hemorrhoids, incarcerated internal hemorrhoids, and anal fissures, incisions are made at 5 o'clock in the skin of the external sphincter and the lower edge of the internal sphincter. Normal patients do not make incisions. After surgery, intravenous infusion of antibiotics and hemostatic agents throughout the body for about 3 days, appropriate oral laxatives, defecation after 24 hours, after the defecation with potassium permanganate solution for a bath, for postoperative edema with 50 grams of warm water bath, each Daily self-made Chinese medicine external agent Shengji Yuhong ointment gauze change dressing.

    3. result

    All cases were cured, the symptoms disappeared, and the hemorrhoids disappeared. The time for hemorrhoids to fall off was 7-14 days, with an average of 9.5 days, and the wound healing time was 18-28 days, with an average of 25 days. 8 cases of postoperative hemorrhage (blood volume above 400ml), 205 cases of postoperative pain requiring narcotic analgesics, 302 cases of obvious postoperative anal edema, 125 cases of re-surgical resection, 52 cases of postoperative urinary retention requiring catheterization In all cases, there was no obvious anal stenosis affecting defecation function.

    4. discuss

    At present, there are many surgical treatment methods for mixed hemorrhoids. The purpose of a variety of improved external stripping and internal ligation is to eliminate the hemorrhoid itself, and only have certain changes in the prevention of postoperative complications and the protection of anal function. The study of the theory of lowering the cushion is in-depth. PPH has solved the problem of partial circular mixed hemorrhoids, but the long-term effect remains to be seen. At present, it cannot replace the external stripping and internal ligation. Therefore, the external stripping and internal ligation of mixed hemorrhoids is still a classic The hemorrhoid surgery method is effective and simple, but its main complications are bleeding, edema, pain and slow wound healing.

    1. Intraoperative hemorrhoid resection range: theoretically, the mother hemorrhoid area is the most common place for hemorrhoids. However, from a clinical point of view, there are generally more hemorrhoids at 11 o'clock, some at 7-9 o'clock, and 5 and 2 o'clock are not uncommon. Therefore, it is not necessary to stick to the so-called female hemorrhoid area during surgery. Circular mixed hemorrhoids should be treated in sections according to the natural depression of the hemorrhoid mucosa. The ligated hemorrhoid pedicles should be staggered up and down, in a jagged shape, leaving enough skin and mucous membrane bridges, generally above 0.5-1.0cm, to prevent anal stenosis . It has also been reported that the large hemorrhoids are artificially divided into two small hemorrhoids, which is easy to ligate and has less bleeding, short shedding time, and light postoperative pain [2]. The treatment of external hemorrhoids should be purely separated to the tooth line. Pay attention to protecting the tooth line area. The wound surface under the tooth line should be folded inward in a fusiform shape. The vein clusters on both sides should be peeled off, and then the incision should be extended outward to facilitate drainage.In recent years, with the in-depth research on the theory of anal cushion shifting down, more and more attention has been paid to the role of anal cushion. The operation of hemorrhoids is not as clean as possible. The purpose of the operation is to relieve the symptoms, not to eliminate the hemorrhoids. During the operation, the hemorrhoids (anal pads) that are not serious and cause no symptoms should be preserved, instead of removing all the hemorrhoid tissues in the mother hemorrhoids. You can use hemorrhoids. Spirit hardening treatment instead. Therefore, some people put forward the "restrictive hemorrhoidectomy" that is in line with the view of modern minimally invasive medicine. While achieving the purpose of treatment, it should minimize surgical trauma and retain relatively normal tissue [3].

    2. Internal sphincter incision: At present, there are many reports of incision of part of the internal sphincter while mixed hemorrhoid surgery. It is believed that it is beneficial to relieve the persistent spasm of the internal sphincter to relieve postoperative pain, prevent anal stenosis and reduce postoperative anal edema[ 4]. The author believes that effective preoperative anal expansion can have the same effect for general mixed patients, and it is not suitable for internal sphincterotomy especially for elderly and weak patients. For patients with partial circular mixed hemorrhoids, incarcerated mixed hemorrhoids and anal fissures, the undercut of the external sphincter skin and part of the internal sphincter can be cut at the same time, and the location should be 5 o'clock behind the anus. After the preoperative local anesthesia, first insert one finger into the anus for digital examination, and then expand the anus with two fingers. The movements should be gentle and slow to 6 or 12 o'clock. After expanding the anus to the four fingers, continue for a while to avoid sudden violent anal expansion. Anal tear and extensive subcutaneous bleeding.

    5. Postoperative pain: Postoperative pain is a major problem of this operation. The incision pain is the most severe 24 hours after the operation. The degree of pain is related to the scope of surgical resection, anal edema, defecation difficulties, sphincter spasm, and patient tolerance. Receiving ability is related, clinically, the author compares mixed hemorrhoids after one or two hemorrhoids and circular mixed hemorrhoids; after circular mixed hemorrhoids, the internal sphincter is cut and not cut, and the postoperative pain of patients is obviously different. During the operation, ligation of the wound of external hemorrhoids should be avoided as much as possible. The wound must be stripped to the tooth line and then ligated. After the operation, massage the anus to bring the ligated hemorrhoids back to help reduce postoperative pain.

    references

    [1] Wang Jingjing et al. Criteria for diagnosis and efficacy of clinical syndromes of traditional Chinese medicine. Changsha: Hunan Science and Technology Press, 1993, 361-362.

    [2] Li Zhixun and others. Clinical observation of ligation of mixed hemorrhoids, stage Ⅱ and Ⅲ hemorrhoids and large hemorrhoids. Chinese Journal of Modern Surgery, 2006, 3 (2): 179.

    [3] Yang Xinqing. Progress in surgical treatment of hemorrhoids. Chinese Journal of Modern Surgery, 2003, 7 (3): 169.

    [4] Li Chunyu et al. Clinical observation of external stripping and internal ligation plus sphincterotomy in the treatment of circular mixed hemorrhoids. Colorectal and Anal Surgery, 2006, 12(3): 172.

    Email: dxm723@nbip.net

hemorrhoids treatment cream,Perianal eczema

    1. What is anal eczema?

    Eczema is also called "soaked sore" and "blood rubella" in Chinese medicine. Eczema that occurs on the skin around the anus is called anal eczema.

    Eczema is divided into acute eczema and chronic eczema. It is a non-infectious, allergic, chronic and refractory inflammatory skin disease that can be affected by both men and women.

    Chronic eczema is a transformation from acute eczema, so chronic eczema is more common, often recurrent, and does not heal for a long time.

    2. What are the causes of anal eczema?

    (1) Disease factors: such as endocrine disorders, liver and kidney dysfunction, intestinal parasites, digestive dysfunction, leucorrhea in women, pinworm disease, etc., can cause or aggravate the disease.

    (2) Anal diseases: such as hemorrhoids, anal fistula, anal fissure, anal incontinence, and anal epithelial defects.

    (3) Allergens: such as pollen, dust, wool, man-made fibers, balsam, dyes, soap, etc.

    (4) Dietary factors: fish, shrimp, crab, beef and mutton, eggs, green onions, garlic, wine, etc.

    (5) Drug effects: sulfa drugs, certain antibiotics, strong acids, strong bases and other chemicals.

    (6) Mental factors: mental stress, fatigue, depression, and insomnia.

    (7) Physical factors: Some people think that poor quality has an important relationship with this disease.

    (8) Others: hot, humid, cold, sunlight and other climate influences.

    3. Can patients with anal eczema wash their anus with hot water?

    Patients with anal eczema often suffer from unbearable local itching and prefer to use hot water to fumigate the skin around the anus to relieve itching for a while. In this way, not only did it not relieve the condition, but it promoted the itching and exudation. This is because the hot water irritates the skin of the anus, causing increased secretions, exudation and soaking, resulting in aggravation of local skin inflammation, making the condition incurable for a long time. Therefore, patients with anal eczema cannot clean the anus with hot water.

    4. What are the principles of treatment for anal eczema?

    According to the different causes and local changes of the disease, conduct reasonable overall treatment and symptomatic treatment, find out the pathogenic factors as much as possible, improve the working environment, living habits, dietary habits and physical fitness that can induce eczema, and actively treat the cause of eczema Systemic diseases and anorectal diseases, such as anal fistula, anal fissure, hemorrhoids, anal itching, constipation and diarrhea and other primary diseases.

    Our department used Ai Cang Kushen Decoction and self-prepared Zhiyang Ling to treat acute primary anal eczema, and achieved obvious effects. [Liu Qiujiang: Fujian Traditional Chinese Medicine 35(1): 41, 2004; Wu Rongfa: Journal of Practical Chinese Medicine 17(3): 35, 2001]

    5. Differential diagnosis of wet and itching anus?

    Anal eczema can be seen thickened perianal skin folds, chapped, and pale skin.

    The anal dampness and itching caused by internal hemorrhoids are mostly caused by increased secretions when internal hemorrhoids become inflamed and enlarged, or because internal hemorrhoids prolapse outside the anus, stimulating large intestinal glands to secrete a large amount of mucus, and the mucus flows out along the loose anal canal. After treatment of internal hemorrhoids, the symptoms of anal dampness and itching will disappear.

hemorrhoids or anal cancer,What is prolapse

    Part or all of the rectal wall shifts downwards, which is called rectal prolapse, commonly known as rectal prolapse. Part of the rectal wall moves down, that is, the rectal mucosa moves down, which is called mucosal prolapse or incomplete prolapse; the full-thickness of the rectal wall moves down is called complete prolapse. If the rectal wall moves down inside the anorectal cavity, it is called internal prolapse; if it moves down outside the anus, it is called external prolapse. Rectal prolapse mostly occurs in children and middle-aged women. Rectal prolapse in children is mostly mucosal prolapse, which usually heals spontaneously before 5 years old. Adult complete rectal prolapse is rare. For example, repeated rectal prolapse can cause pudendal nerve damage and anal incontinence, and may cause rectal ulcers, bleeding, stenosis, and necrosis, requiring surgical treatment.

    The cause of rectal prolapse (rectal prolapse) is not fully understood, and it is believed to be related to many factors.

    1. Anatomical factors

    Stunted infants, malnourished patients, and the elderly are prone to weakness and weakness of the levator ani muscle and pelvic floor fascia; the sacrum is small and straight in children; factors such as surgery, trauma, and peripheral anorectal muscles or nerves can be weakened The fixation and support of the tissues around the rectum make the rectum easy to prolapse.

    2. Increased abdominal pressure

    Such as constipation, diarrhea, enlarged prostate, chronic cough, dysuria, multiple childbirths, etc., often cause the abdominal pressure to rise and push the rectum downward to prolapse.

    3. Other

    Internal hemorrhoids and rectal polyps often prolapse, and the rectal mucosa is pulled downward to induce mucosal prolapse.

    What are the symptoms of prolapse?

    The main symptom is prolapse of a mass from the anus. The tumor was small when it first appeared, prolapsed during defecation, and reset itself after defecation. Afterwards, the masses gradually prolapse and increase in volume, and they need to be returned to the anus with hands after defecation, accompanied by a feeling of incomplete defecation and falling. Finally, it can come out when coughing, straining or even standing. As the prolapse worsens, different degrees of anal incontinence are caused, and mucus often flows out, leading to eczema and itching of the perianal skin. Due to difficulty in emptying the rectum, constipation often occurs, and stools increase frequently, which looks like sheep feces. The mucous membrane is eroded and blood flows out after ulceration.

    How to distinguish anal prolapse and internal hemorrhoids?

    1. Blood in the stool

    The early stage of internal hemorrhoids is mostly painless blood in the stool, sometimes dripping blood, sometimes spurting blood or sticking blood on the toilet paper; and the main symptoms of prolapse of the anus are prolapse of the anal canal and mucous membrane, and blood in the stool is rare.

    2. Pain

    The internal hemorrhoids are generally painless in the early stage, and severe pain is unbearable after incarceration in the later stage; and prolapse of the anus is sometimes accompanied by severe pain.

    Three, mucus

    Internal hemorrhoids often have symptoms such as wet anus, while prolapsed anus often has mucus overflowing from the anus. The two symptoms are similar.

    Four, prolapse

    The prolapse of internal hemorrhoids is the hemorrhoids, usually hemorrhoids do not prolapse in stage I, and hemorrhoids prolapse only in stages II and III, and sometimes incarceration occurs in the late stage; and the rectal mucosa, anal canal and rectum are prolapsed in the late stage. It can reach more than ten centimeters.

what does a hemorrhoids look like,Should prevent anorectal diseases in summer?

    Summer is the season of high incidence of anorectal diseases such as hemorrhoids. Hot summer weather, excessive fatigue, insufficient rest time, etc. often make the gastrointestinal turbidity cannot be discharged in time, and congestion can cause hemorrhoids in the anus. In addition, in summer, people like to eat spicy food, various barbecues, and drink cold beer, which greatly increases the problems of dry stool and difficulty in defecation, and constipation is an important factor in inducing hemorrhoids. In addition, food is prone to spoilage in summer, and a little carelessness can easily cause acute gastroenteritis, leading to diarrhea and the onset of diseases such as hemorrhoids. As for those white-collar workers who sit on soft seats for a long time, they can easily cause hemorrhoids because of the lack of exercise due to prolonged sitting and lack of exercise.

    In order to prevent anorectal diseases, experts remind that special attention should be paid to the following points in summer:

    1. Emotional aspects

    Excessive thoughts can damage the spleen and stomach, or be irritable and angry, leading to stagnation of liver qi, resulting in stagnation of qi and blood, blockage of the meridians, and interlacing of collaterals and hemorrhoids.

    2. Diet

    Don't eat iced food directly, don't be greedy for cold drinks, don't drink a lot of alcohol, don't overeat spicy food, eat less pickled products, barbecue, and fatty food. You should eat more fiber-rich foods such as whole grains, vegetables and fruits to increase bowel movements, maintain smooth bowel movements, eliminate intestinal harmful substances and carcinogens, prevent constipation, and reduce the occurrence of anorectal diseases.

    3. Defecation habits

    Get up early with a glass of cold boiled water, light salt water or honey water to stimulate gastrointestinal peristalsis, and develop the habit of defecation half an hour after waking up or after breakfast. If you have the intention of having a bowel movement, you can't force it. Don't read books, newspapers, play mobile phones, play games, squat for a long time, or use excessive force during defecation. Establish regular defecation regularity. In short, maintaining a normal defecation regularity has a certain positive effect on anal health and strengthening physical fitness.

    4. Partial exercise

    Do levator anus exercises every morning and evening to improve local blood circulation and enhance anal sphincter function for 10-30 minutes each time to increase muscle tension and reduce the occurrence of anorectal diseases such as hemorrhoids or prolapse.

    5. Hygiene

    It is easy to sweat in the hot summer, especially to keep the local area clean and dry. Wash the perineum and anal area with warm water after defecation and before going to bed. Change underwear and underwear frequently to keep the area clean and stay away from anorectal diseases.

    6. Work

    Avoid sitting for a long time, standing for a long time, and squatting for a long time at work. You should pay attention to the combination of work and rest. Work properly for a certain period of time to improve local blood circulation and reduce the occurrence of various anorectal diseases.

    The above are some ways to prevent anorectal diseases. As long as we pay a little attention in our daily life, we can prevent and reduce the occurrence of anorectal diseases and spend the summer safely.

preparation h hemorrhoids,Such people are prone to bowel cancer, so be careful

    Cancer is a disease with a relatively high incidence but a very low cure rate. There are now very many people suffering from cancer. There are many causes of cancer, and unreasonable lifestyle and diet are the main causes of cancer. So who is susceptible to bowel cancer? Let me explain it for everyone!

    From the two diseases of hemorrhoids and rectal cancer, hemorrhoids is the most common benign anal disease, and rectal cancer is a malignant tumor with a high incidence of digestive tract. If not diagnosed and treated early, it can be life-threatening. Therefore, experts especially emphasize that stool bleeding should be highly vigilant, not to diagnose hemorrhoids lightly. Even if you have hemorrhoids, you must be alert to the possibility of bowel cancer, which must be further checked and ruled out.

    What are the other early symptoms of rectal cancer?

    1. Bloating, abdominal pain

    The reason is due to intestinal dysfunction or intestinal obstruction. The parts are mostly concentrated in the middle and lower abdomen, mostly dull or swelling pain, and there is a tendency to gradually get worse.

    2. Blood in the stool

    Because the lesion is close to the anus, the blood color is mostly bright red or dark red, and the blood is often separated from the stool. Only when the amount of bleeding is large, the stool is brown-red and jam-like. This is the case in patients with right colon cancer, and 36.5% of them have visible blood in the stool. This is also the early symptoms of colorectal cancer.

    3. Anemia

    When the long-term chronic blood loss exceeds the compensatory function of the body's hematopoiesis, the patient can develop anemia, an early symptom of colorectal cancer. Tumor obstruction, when the tumor grows to a considerable size or infiltrates the muscular layer of the intestinal wall, it can cause intestinal stenosis, the intestinal lumen becomes smaller, and the passage of intestinal contents is blocked.

    4. Changes in stool habits and traits

    Patients with rectal cancer may have more bowel movements, but they do not defecate much each time, or even have no feces at all. They only discharge some mucus and blood, and have a feeling of incomplete defecation. When the colorectal tumor is relatively large and has erosions, ulcers or infections, changes in bowel habits, frequency, and constipation or unexplained diarrhea may occur. If the cancer protrudes and grows into the rectal cavity, resulting in a relatively narrow intestinal cavity, the excreted stool is often thin and deformed, and may be flat, and sometimes some bloodshots are attached to the deformed stool.

    What kind of people are prone to bowel cancer. Patients who have had colorectal polyps are more likely to have intestinal malignancy; people with severe ulcerative colitis that have not cured for many years need to be alert to intestinal malignancy; have undergone cholecystectomy for 10 years The above-mentioned people need to be alert to intestinal malignant changes; people who regularly consume high-protein and high-fat foods, smoke regularly, and drink alcohol.

    Postoperative diet care for bowel cancer should be noted: the diet of patients after bowel cancer surgery should be diversified, not partial, not picky, do not eat a high-fat and high-protein diet for a long time, and often eat fresh vegetables and anti-cancer foods. Spicy and irritating food should not be eaten after bowel cancer surgery, so as not to stimulate wound healing. The diet should be light and less oily, and sesame oil can be used. Patients should eat more foods high in protein and iron, such as animal liver, lean meat, poultry eggs, milk, crucian carp, duck soup, longan, white fungus, soft-shelled turtle, etc., to supplement the patient's varying degrees of blood loss during surgery.

    What causes colorectal cancer?

    Studies have shown that factors such as diet, environment, genetics, and ethnicity are all related to the incidence of colorectal cancer. The dietary factors and environmental factors are more important. Take Japan as an example. In the 1950s, Japan was the same as China, and it was a country with a lower incidence of colorectal cancer. With the economic recovery and development after the war, the incidence and mortality of colorectal cancer in Japan are also increasing. According to statistics from the Japanese Cancer Society, from 1947 to 1978, the mortality rate of colorectal cancer increased approximately twice, while other cancers such as lung cancer only increased by 60%, gastric cancer and cervical cancer decreased by 30% and 60% respectively.

    Analyze the reasons. First, it is caused by an increase in fat diet and a decrease in fiber diet. In recent years, the incidence of colorectal cancer in cities in China has increased, which is also related to changes in diet. Second, the environment is closely related to colorectal cancer. The main environmental factors are: lack of selenium in the soil; the impact of schistosomiasis. In China, the high-risk area of ​​schistosomiasis is also the high-incidence area of ​​colorectal cancer; smoking can easily cause colorectal cancer. The third is genetic factors. About 10% of colorectal cancers are related to genetic factors. Therefore, the offspring of patients diagnosed with familial colorectal polyposis, hereditary non-polyposis colorectal cancer, and sporadic hereditary colorectal cancer should be closely followed up. At the same time, some benign tumors of the large intestine called polyps cannot be ignored. People who suffer from ulcerative colitis for a long time also have a greater chance of getting colorectal cancer.

    In summary, people with one of the following conditions should be regarded as high-risk groups of colorectal cancer: adults in high-incidence areas of colorectal cancer, such as large cities in China and the southeast coast; patients with colorectal adenoma, have multiple families Family members of gonadenomatosis; patients who have had colorectal cancer before; patients with schistosomiasis; family members of patients with colorectal cancer; members of cancer family syndrome; people who have received radiation therapy in the pelvis (someone reported that they are susceptible to rectum after 1020 years of pelvic radiotherapy Cancer); patients with chronic ulcerative colitis. Some people believe that the chance of colorectal cancer in people with this disease is 10 times higher than that of normal people.

    1. Daily diet should not be too fine

    Polished rice white flour, high in sugar, may affect blood sugar and triglyceride levels. These factors can directly or indirectly act on the epithelial cells of the large intestine through various hormones such as insulin to promote canceration and induce colorectal cancer. Therefore, prevent colorectal cancer. Daily diet It should not be too fine.

    2. Heavy taste habits are not advisable

    People with colorectal cancer who don't like heavy flavors should make corrections if they like pickled meat, fried, and spicy products, because these are important factors that induce colorectal cancer. Therefore, to prevent colorectal cancer, we must pay attention to a balanced diet, eat more fresh fruits, vegetables and other foods rich in vitamins and fiber to promote gastrointestinal peristalsis and prevent colorectal cancer.

    3. Abandon greasy eating habits

    Excessive consumption of animal fat will increase the burden on the intestines, accumulate fat metabolites to produce carcinogens, induce colorectal cancer, and if there is a lack of carotene, vitamin C, E, D, folic acid and methionine in the diet or lack of minerals, it can also be induced Colorectal cancer. Therefore, we must abandon greasy eating habits to prevent colorectal cancer.

    6 tips to cook smartly to prevent bowel cancer

    1. Use iron pans and use less non-stick pans or stainless steel pans. Cooking in an iron pot can increase the iron content of food and help prevent bowel cancer. The anti-sticking substance coated on the surface of the non-stick pan can enter the food. Ingestion of this substance in large quantities can cause cancer to the human body. The stainless steel pan contains heavy metals such as iron, chromium, and nickel. Heavy metals will be incorporated into food, among which hexavalent chromium has serious carcinogenic effects.

    2. Use less frying, stir-frying and other methods to cook meat directly. You can wrap the raw materials in batter and then fry them. Although cooking methods such as deep-frying and stir-frying can make delicious dishes, there are more carcinogens in fried meatballs, fried fish, and fried steaks. This is because the protein in the meat will produce carcinogens after high temperature. Therefore, people can wrap a layer of batter on the raw materials and then fry them.

    3. Vegetables should not be soaked for a long time. They should be washed first and then cut, fried and eaten after they are cut, otherwise the vitamins in the vegetables will be lost.

    4. The temperature during cooking should be controlled within 180℃, and no continuous high-temperature frying. If the oil temperature is too high, do not cook for more than 2 minutes. This can effectively reduce carcinogens in food and prevent bowel cancer.

    5. Use vinegar when cooking to protect vitamins from being decomposed and prevent bowel cancer.

    6. Brush the pot every time you cook a dish. There may be carcinogens in the pot scale left over from the previous dish, so you must clean the pot after each dish.

    5 kinds of vegetables that can prevent bowel cancer in life

    Bean sprouts

    The chlorophyll in bean sprouts can prevent and treat bowel cancer, especially rectal cancer. The abundant aspartic acid can reduce the accumulation of lactic acid in the body and help eliminate fatigue. Traditional Chinese medicine believes that bean sprouts are sweet and have the effects of clearing away heat, detoxifying, and promoting dampness.

    Gracilaria

    This product contains asparagine, aspartic acid and a variety of steroids, and has certain effects on fatigue, edema, and dysuria. The United States found that this vegetable has the function of preventing the spread of cancer cells, and has special effects on bowel cancer, lymphoid granulation tumors, bladder cancer and kidney stones. The main anti-cancer component is the paraginase in tissue protein, a substance that normalizes cell growth and can effectively control the growth of cancer cells. Asparagus must be cooked before eating. It is best to eat before meals.

    cabbage

    Cabbage has the effects of nourishing bone marrow, strengthening joints, strengthening bones, organs and clearing heat and pain. At present, it is known that indole-3-acetaldehyde and flavonoids contained in it can induce 54 times increase in the activity of hydrocarbon hydroxylase in the liver, increase the activity of this enzyme in the small intestine mucosa by 30 times, and reduce gastric cancer and intestinal cancer. Chance of onset.

    carrot

    It has the effects of invigorating the stomach and spleen, promoting body fluid and replenishing qi, and has the effect of laxative and stasis for accumulating chancre. The carotene contained is an anti-cancer nutrient. ,

    Lentils

    Lentils have the functions of invigorating the spleen, dehumidifying, relieving heat and detoxification. This product can be used for gastrointestinal tumors with weak spleen and dampness and internal resistance. It can stimulate lymphocytes in the body to transform into tumor-killing cells, and can stimulate the human immune system to improve digestion and absorption.

    Conclusion: Many people are afraid of cancer. Therefore, if we want to stay away from the threat of cancer, we must do a good job in preventing cancer. From the above knowledge, we can see that we can prevent cancer through diet or exercise. Hope the above knowledge can help everyone!

what does a hemorrhoids look like,What you need to know about anorectal surgery

    The various complications of anorectal surgery are of great concern to all patients. Although we will communicate with patients in detail after the operation, many patients are still at a loss when encountering specific situations. This article teaches you how to Deal with complications after anorectal surgery.

    1. Postoperative pain: Postoperative pain is a very common complication. Patients with a lower pain threshold are more sensitive to pain. For patients with hemorrhoids, the pain is more or less 7 days after surgery. The more wounds and the more sutures, the more pain they feel. The pain will be greatly relieved after the sutures are removed in 7 days. For patients with abscesses, it will be painful to change the dressing 1 week after the operation, and the pain will be greatly relieved after 2 weeks. After the operation, you can take Le Song (one tablet 3 times a day after meals) to relieve pain. If the pain does not relieve, you can inject an intramuscular injection of painkiller. Individual patients with large abscess cavity can apply tetracaine glue to the wound to relieve pain before changing dressing.

    2. Postoperative bleeding: Postoperative wound oozing, blood in the toilet paper, and blood in the stool are more common. Don't panic in this situation. Generally, blood in the stool will no longer occur 2 weeks after the operation. For patients with hemorrhoids, stay in bed for 2 weeks after surgery and do not do heavy physical labor. If there is bleeding during the stool and a large number of blood clots flow out from the anus, they must come to the hospital for treatment. Generally, hemorrhage occurs. The probability is very low.

    3. Urinating after operation: After the operation, hemostatic gauze will be plugged in the anus, and gauze will be pressed to stop bleeding outside the anus. The pressure of gauze and the influence of anesthesia may cause postoperative urination. You can use a hot towel to compress the lower abdomen and massage the sacrum to help urinate. In our department, surgery is performed in the morning. Most patients urinate in the afternoon or evening, and some patients also urinate in the early morning at the latest. Some patients become very anxious because they did not urinate, and feel that their lower abdomen is distended and painful, but the physical examination actually does not have much urine. So take it easy, let it go, urinating can be resolved naturally, according to my experience, there are not many patients who need postoperative catheterization. Of course, if you really can’t resolve your urine, you can ask the doctor on duty to take a shot to help you urinate. If you still can’t resolve your urine after the injection, you need to catheterize, and the catheter is left for 2 days.

    4. Postoperative diet: According to the doctor's explanation, you can drink water and eat porridge (diabetic patients can eat steamed eggs) when you return to the ward after the operation. You can only eat porridge on the day after surgery (no vegetables can be added to the porridge). On the second day after surgery, you can eat noodles and hand-offs. Diabetic patients eat a diabetic diet. You can eat normally on the third day after surgery, such as rice, meat, milk, vegetables, and fruits. But avoid spicy, greasy, beef and mutton, chicken, etc. Patients with hemorrhoids should avoid high-fiber vegetables such as leeks, celery and enoki mushrooms.

    5. Postoperative defecation: Oral laxatives before going to bed at night after surgery, and the first bowel movement can be performed on the third day after surgery. If individual patients do not insist on the third day after surgery, it will be on the second day after surgery. Stool in the afternoon is also fine. If there is no bowel movement on the third postoperative day, then the bowel movement on the fourth postoperative day is also normal. If you always want to have a bowel movement but do not come out, you can tell your doctor. The defecation time should not be too long, it is advisable to control it within 5 minutes. After the bowel movement, use Chinese medicine to take a sitz bath and control the sitz bath time within 5 minutes. Dressing can be changed after the sitz bath.

    6. Postoperative wound edema: Postoperative wound edema is a more common complication, and it occurs more frequently in female patients. It may be caused by too long a bowel movement or a long bath time. Wound edema should be treated with topical drugs for a period of time, such as hemorrhoid suppository, hemorrhoid cream, etc. Small skin tags will be left after the edema disappears.

hemorrhoids essential oils,Analysis on the formation mechanism of hemorrhoids

    Anatomically, the superior rectal vein in the human body is a blood vessel with a long stroke, and it lacks a venous valve that can prevent venous blood reflux. Therefore, the blood in the blood vessel can generate downward hydrostatic pressure. In addition, the pressure in the abdomen increases during defecation, and the distal end of the rectal vein can expand to form hemorrhoids.

    There are 3 thickened areas on the surface of the lower rectum and upper anal canal, which are called "anal vascular liners", which are composed of blood vessels, smooth muscles, elastic fibers and structural tissues. Normally, the vascular liner is only loosely attached to the muscle ring below it. When the muscle ring is relaxed during defecation, the vascular liner will turn outwards towards the anal orifice and cannot be completely reset. Hemorrhoids will be formed over time. Some people have abnormal contraction of the muscles of the anal orifice, which makes the anal orifice narrow and increases the pressure. It is necessary to increase the force of defecation to pass stool. This affects the normal bowel function and process, increases intra-abdominal pressure, venous congestion, and forms hemorrhoids.

what does a hemorrhoids look like,Pay attention to preventing anorectal diseases in summer

    After the beginning of summer, with the rise in temperature, the incidence of some damp-heat-related diseases is also increasing. Anore...