2020年9月9日星期三

what is a hemorrhoids,What are the consequences of hemorrhoids

    Hemorrhoids are the most common anorectal disease. According to a survey conducted in China in 1997, the incidence of hemorrhoids is as high as 87.5%, which is close to the Chinese folk saying "nine hemorrhoids in ten people", and the incidence of women is slightly higher than that of men. There are two theories about the formation of hemorrhoids. One theory believes that hemorrhoids are formed by pathological tortuosity, expansion and blood stasis in the venous plexus under the mucosa of the rectum or under the skin of the anal canal. Another theory believes that there is a special structure formed by blood vessels, smooth muscle, elastic tissue and connective tissue under the mucous membrane of the rectum. It is called "anal cushion". Its function is to assist the tight closure of the anus, just like the rubber gasket of a faucet. Function: When the anal cushion is loosened, enlarged, or moved downward, it will be complicated by the expansion of venous plexus stasis, thereby forming hemorrhoids. These two theories are interrelated and complement each other.

    So, what are the consequences of hemorrhoids?

    The main symptoms of hemorrhoids are "blood in the stool" and "hemorrhoids prolapsed."

    1. Hemorrhoids can cause iron deficiency anemia.

    Repeated bleeding during bowel movements can cause a large amount of iron to be lost in the body and cause iron deficiency anemia. Iron is an indispensable and important element in red blood cells. Under normal circumstances, the absorption and excretion of iron are balanced, and the loss of iron is very small. Normal adult men lose no more than 2 mg of iron per day; while patients with hematochezia lose more than 3 to 4 mg of iron if their daily blood loss exceeds 6 to 8 ml. The total iron content of normal human male is 50 mg/kg body weight, and the total iron content of female is about 35 mg/kg body weight. If you have blood in the stool for a long time and lose a lot of iron, making the total iron content in your body lower than normal, it will cause iron deficiency anemia.

    2. Hemorrhoids can cause incarcerated hemorrhoids and their complications.

    Another major symptom of hemorrhoids is prolapse of hemorrhoids. As the anal cushion is loose, broken, and sagging, the hemorrhoids will eventually prolapse. The hemorrhoids protruding outside the anus are further clamped by the sphincter, causing the venous return to be blocked, and the continuous input of arterial blood makes the hemorrhoids larger and larger; until the arterial blood vessels are compressed and thrombosis, the hemorrhoids become hard and painful , It is difficult to return to the anus, at this time it is called "incarcerated hemorrhoids".

    If a hemorrhoid is incarcerated for a long time, the following complications may occur.

    1. Necrosis: Hemorrhoids are incarcerated outside the anus. Due to a series of pathological changes, local metabolites accumulate, which further aggravates local anal edema and aggravates the incarceration of hemorrhoids. This is a vicious circle. Therefore, if the internal hemorrhoids are incarcerated for a long time, necrosis will eventually appear. At the beginning, the necrosis is limited to the mucosal part of the hemorrhoids, but if the incarceration continues, the necrosis will extend to the depths, which may eventually lead to serious infections. It has been reported abroad that the thrombus in the hemorrhoids spread upward, and the necrotic area extends to the rectal wall, resulting in severe sepsis in the pelvic cavity. Although this situation is rare, it must arouse the attention of clinicians.

    2. Infection: After hemorrhoids are incarcerated, they often have different degrees of infection. The patient may have symptoms such as tenesmus and anal swelling. At the beginning, the infection is mostly localized in the anus. If repositioned barely, the infection may spread and cause submucosal Or deeper infections, or even perianal or ischial rectal fossa abscess; if the shed bacterial embolus runs along the vein, coupled with improper use of antibiotics or no antibacterial drugs, it may form portal bacteremia or even sepsis. Can form liver abscess. There have been reports of fatal portal sepsis caused by hemorrhoid incarceration abroad.

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