2020年10月30日星期五

hemorrhoids essential oils,A minimally painful and minimally invasive method for treating hemorrhoids

    Clinical observation of copper ion electrochemical therapy combined with external hemorrhoidectomy in the treatment of mixed hemorrhoids

    Li Dongbing Xie Zhennian

    Prolapse

    . keep changing. The most common, there are data showing that hemorrhoids in mixed hemorrhoids are clinically common and frequently-occurring diseases. Among them, mixed hemorrhoids are the most common, and data show that mixed hemorrhoids account for about 65.9% of hemorrhoid patients. The treatment of hemorrhoids is constantly changing with the renewal of understanding of hemorrhoids and the innovation of methods. Prolapse, bleeding, and pain are the main symptoms of hemorrhoids. There are many treatment methods for hemorrhoids. The external stripping and internal ligation (Milligan-Morgan operation) was once the most commonly used surgical method in clinic. Although this method is simple, it has severe postoperative pain, slow wound healing, long hospital stay and may produce anus Complications such as stenosis affect the ability of fine bowel control and defecation in the anus, and require high tolerance for patients, which cannot be tolerated by elderly, frail, and severely ill patients. Stapling prolapse and hemorrhoid circumcision anastomosis (PPH) has been widely used clinically in the past 10 years, but its cost, postoperative rectal stenosis and discomfort have been criticized. Although various methods of continuous improvement have emerged one after another, and each of these surgical methods has certain advantages, but it may not fundamentally solve the above-mentioned shortcomings, or the effect is not good. In 1998, electro-chemical therapy by cupric ion (ECTCI) was used to treat hemorrhoids. Afterwards, many experts studied it and believed that the pain was less and the complications were less. External resection) achieved good results. At the same time, a randomized controlled study was carried out with external stripping and internal ligation and PPH combined with external resection.

    1 Treatment method

    Enema was performed 2 times before operation, and the sacral canal was anesthetized.

    ECTCI treatment: Insert a bell-mouth anoscope, check the bleeding and prolapsed hemorrhoid area, insert 4 sets of copper needle electrodes into 4 hemorrhoid tissues near the tooth line at a depth of 15 mm, and treat for 280 s. Pull out the electrode, the cotton ball presses the needle eye to prevent the copper ionic liquid from overflowing. Use the same method to treat the remaining hemorrhoids successively. The same hemorrhoid area can be treated repeatedly at the same time according to bleeding and congestion. General treatment is not less than 3 times. After the treatment, take out the anoscope and observe the reaction of the hemorrhoid during the treatment. Generally, you can see the blue-green changes in the tissue around the electrode that appear in the ECTCI treatment. After the operation, hemorrhoids and Ning Suppository were built in the anus, and hemostatic dressing was applied and bandaged.

    Postoperative treatment: All patients in the 3 groups were treated with antibiotics for 3 days after the operation. They had a normal diet on the day of the operation. They were cleaned with Qudu Erhuang Decoction after defecation, and the dressing was changed routinely until they recovered.

    2 Results:

    1. Efficacy of hemostasis: 100% cure rate after hemostasis. 2. Curative effect of treatment of prolapse: the cure rate is 95.8%. 3.

    Postoperative pain: After t-test, the pain score (24 hours after surgery, postoperative bowel movement) in the treatment group was significantly lower than that in the control group 1 and control group 2. There is statistical significance (P<0.01). 4. Various complications: in terms of postoperative bleeding, edema, urinary retention, delayed healing, anal stenosis, anal swelling, and decreased ability to control stool, the number of cases in the treatment group was significantly less than that of the control group 1 and the control group 2. , The difference was statistically significant (P<0.05).

    5. Comparison of hospitalization days, recovery time, and cost: The number of hospitalization days, recovery time, and costs in the treatment group were significantly less than those in the control group 1 and control group 2, and the difference was statistically significant (P<0.05).

    Explore the treatment of hemorrhoids. Choosing safe, fast, effective, and less painful treatments is the main criterion.

    According to many years of clinical efficacy observations, the long-term effects of drugs and non-incision surgical methods are not as good as that of incisional surgery. However, the obvious pain and complications of incision surgery are always the key issues affecting the direction of treatment. In the past, the fear of surgical treatment of hemorrhoids was mainly painful and prone to sequelae. And its essence is to solve: (1) control of bleeding; (2) resolution of infection; (3) skin protection. Based on the above considerations, in the past, external stripping and internal tying methods were used to solve infection and bleeding problems. But at the same time, it is necessary to reduce the local damage of the operation, try to keep the skin in the anal area intact, and avoid complications such as anal canal defect and anal stenosis. The core of the contradiction and limitation of this treatment method is that it is limited by historical conditions, considering the integration of internal and external hemorrhoids, and mixed treatment of mixed hemorrhoids. The possible countermeasures are: (1) reduce the wound; (2) perform the operation in a painless area; (3) suture the wound. Based on the above ideas, the different situations of hemorrhoids should be dealt with accordingly. The basic tips are: internal treatment of internal hemorrhoids; external treatment of external hemorrhoids; underestimation of the anal margin; protection of the anal canal. Under the guidance of this ideology, we have used and continuously innovated the current two technologies (ECTCI, PPH stapler) for the treatment of internal hemorrhoids, combined with the electric knife to complete the resection of external hemorrhoids, and applied the necessary anal expansion method. This study shows that the treatment The hospital stay of the group was significantly shorter than that of the control group, and successfully solved all the surgical problems of hemorrhoids.

    Classification and indexing of hemorrhoids. Due to the principles of internal treatment of internal hemorrhoids and external treatment of external hemorrhoids, from the perspective of guiding treatment, according to the location of hemorrhoids, it is divided into: (1) Internal hemorrhoids. According to the degree of bleeding and prolapse, it is divided into 4 degrees. (2) External hemorrhoids. Divided into 4 categories: ① Thrombosis. ② Varicose veins. ③Connective tissue. ④ Inflammation. Mixed hemorrhoids commonly called in China have no meaning. From the perspective of guiding treatment, the classification of internal and external hemorrhoids is more practical. From clinical experience, the degree of bleeding and prolapse are the main indicators to guide treatment, and circular prolapse and non-circular prolapse should be the main basis for selecting treatment methods. The diagnosis of mixed hemorrhoids has lost its clinical significance.

    The theoretical basis of ECTCI plus external resection: ECTCI was developed from the traditional Chinese medicine dry hemorrhoid nail therapy, but dry hemorrhoid nail is painful and the long-term effect is not ideal. ECTCI is based on the principle of the hemorrhoid nail therapy, combined with modern technology, using copper needle electrodes to quickly release complexes similar to the foreign body stimulation of the hemorrhoid nail, and produced by the method and theory of electrochemical therapy. The emergence of technology rejuvenated the treatment concept of kuehemorrhoids nail therapy and demonstrated the charm of traditional Chinese medicine surgery to treat diseases. ECTCI is treated by iontophoresis and electrification, and the complex formed as a foreign body stimulus and electric current together cause local microthrombosis and vascular wall epithelial cell edema, promote aseptic inflammation, tissue organization, vascular occlusion and lead to surrounding tissue fibrosis , So as to achieve the purpose of eliminating hemorrhagic lesions of submucosal blood vessels and preventing prolapse. This therapy produces curative effects under the combined influence of physical, chemical, and foreign body stimulation. Including: (1) The blockage of small blood vessels leads to the interruption of blood supply to hemorrhoids, which promotes the atrophy of congested and swollen hemorrhoids, and achieves the effect of hemorrhoidectomy in the sense of hemostasis. (2) Effectively and safely cause aseptic inflammation and further promote the fibrosis of Treitz muscle rupture, so that the loose supporting tissues can be adhered, fixed, and lifted, leading to further atrophy of hemorrhoid tissue or anal pad. The trace copper ion itself is non-toxic, stable and safe, which makes up for the shortcomings of traditional methods. Therefore, the copper ion electrochemical treatment is suitable for the treatment of mixed hemorrhoids and internal hemorrhoids. For the external hemorrhoids, we advocate resection together, which is the same as the treatment of PPH.

    This study shows that the operation of ECTCI plus external resection is simple, the operation time is short, with an average of about 20 minutes, and the requirements for patient tolerance are extremely low. Especially when the curative effect is equal to or better than that of PPH and external stripping and internal ligation surgery, it has the characteristics of less pain, quick postoperative recovery, and no obvious complications. It has less disturbance to the patient's physiology, life, and work, and can be used as an elderly person. , The first choice for the treatment of frail and severely ill patients.

hemorrhoids female,Discussion on the relationship between hemorrhoids and sub-health

    Abstract "Ten people with nine hemorrhoids" means that there are more patients suffering from hemorrhoids, but most people's hemorrhoids are asymptomatic and can be treated as a sub-health state. Follow the motherland's medical principles of disease prevention, actively intervene and regulate from the perspective of sub-health, block the development of sub-health to disease, focus on prevention, and go to work to treat the disease, which has positive medical and social significance for preventing the onset of hemorrhoids.

    Key words hemorrhoids, sub-health, prevention of disease, intervention and regulation

    Hemorrhoids is an ancient disease unique to human beings. It is a common and frequently-occurring disease. In most cases, hemorrhoids are in an asymptomatic manifestation, and sub-health is a non-disease and unhealthy transition between health and disease. State is a dynamic process. Therefore, asymptomatic hemorrhoids can be considered as a sub-healthy state. The correlation between them is now discussed.

    1 Hemorrhoids and sub-health meaning

    1.1 The meaning of hemorrhoids Chinese medicine has known hemorrhoids for a long time. Hemorrhoids are considered to be "post disease", which refers to the disease of the posterior vagina and anus. However, the ancients said hemorrhoids have a very broad meaning, not just referring to hemorrhoids. Most of the lesions that occur in the anus are included in the category of hemorrhoids, such as polyps, anal fissures, anal papillary hypertrophy, rectal cancer, etc. In 1975, Thomson first proposed the modern concept of anal cushion and hemorrhoids, expounding the theory of anal cushion downward movement in hemorrhoid formation. Anal cushions are normal, and hemorrhoids are diseases. In the past few years, the academic circles have discussed the right or wrong of the understanding of "anal cushions are hemorrhoids", and gradually reached a consensus, and developed a modern definition, that is, hemorrhoids are pathological Masses formed by hypertrophy, displacement, and stagnation of blood flow in the subcutaneous vascular plexus perianal. When there are no clinical symptoms, internal hemorrhoids of degree I are difficult to define with the anal cushion.

    1.2 The meaning of sub-health In the second half of the 1980s, the international medical community proposed sub-health as a new medical thinking model. Now the medical community has listed it as the number one enemy that affects human health in this century. Sub-health refers to a transitional state between disease and health. It is caused by the intersection of physical, psychological, and social factors. At this time, there may be subjective discomfort, but it does not affect the exercise of social functions. According to estimates from incomplete statistics, 70% of the population in China is currently sub-healthy, but whether it is correct or not is questionable. In 2003, a statistics report on the health examination of community residents in Beijing showed that among the top ten diseases of 1,476 sub-healthy people, hemorrhoids ranked third, which is in line with the folk saying of "ten people and nine hemorrhoids", and there are no symptoms of hemorrhoids. It is universal.

    2 Sub-healthy manifestations of hemorrhoids

    Sub-health is an intermediate state between health and disease, namely health, sub-health, and disease. Sub-health is a "common problem" faced by contemporary society. Its symptoms are manifested in the psychological and physical aspects, involving a very wide range of symptoms, and the main body systems are dysfunctional, such as cardiovascular, digestion, bones and joints, nerves, and spirits. Psychology, sleep, urinary, etc. may have more or less symptoms. As an anal hemorrhoid, there may be slight anal discomfort or asymptomatic in sub-health state. Sometimes there may be a slight bloody wiping during stool, and the anus is slightly swollen and moist and sticky. Most people do not treat it as a disease for clinical diagnosis and treatment, and do not perform clinical medication. Rest and warm water bath to clean the anus can often relieve it. Asymptomatic hemorrhoids are relative. Internal hemorrhoids can be divided into 4 degrees. They can also show prolapse when there is no bleeding. People often ignore their existence; connective tissue external hemorrhoids have anal skin tags and varicose external hemorrhoids during defecation. Protrusion can make the anus wipe dirty after defecation, and people don't take it as a clinical symptom. Therefore, we can consider the hemorrhoids, which have no obvious clinical symptoms and are often overlooked at this time, as a sub-health state of hemorrhoids, and re-understand the treatment of hemorrhoids from the perspective of sub-health, which will have important clinical and preventive medicine significance.

    3 Treatment of hemorrhoids

    The 2006 Hemorrhoids Clinical Diagnosis and Treatment Guidelines describes the treatment principles of hemorrhoids. Asymptomatic hemorrhoids do not require treatment. The purpose of treatment is to eliminate and relieve the symptoms of hemorrhoids. Relieving the symptoms of hemorrhoids is more meaningful than changing the size of hemorrhoids, and should be regarded as the standard of treatment effect. "No need for treatment" here should be understood as clinical medication and surgery. Sub-health is a special form of the so-called "pre-diseased" in Chinese medicine. As hemorrhoids in sub-healthy state, we should deal with it from the perspective of "preventive treatment". Pre-preventive treatment is an important prevention and treatment idea of ​​the motherland medicine. "Four Qi Tiao Shen Da Lun" states that "the saint does not cure the disease before the disease is cured, and he does not cure the disease before the disease." The idea of ​​"preventing disease" in the "Internal Classics" has deep connotations such as prevention before disease, prevention of micro-grading, and prevention of existing disease. . "No disease" runs through the various periods of disease-free state, concealment of the disease, and onset without transmission. For patients with hemorrhoids, prevent symptoms from occurring when hemorrhoids are asymptomatic, and avoid the agitation of hemorrhoid symptoms when the anus is slightly uncomfortable. Hemorrhoids, as a disease, should be prevented from complicating other diseases. This is the "treatment of hemorrhoids in a sub-healthy state." "Three levels of understanding. If we can actively intervene and control, so that patients suffering from hemorrhoids can stay asymptomatic for a long time. Although hemorrhoids cannot be eradicated, hemorrhoids in sub-healthy state can reach a healthy state to the limit. .

    4The significance of coping with sub-healthy hemorrhoids

    "Huainanzi" says: "A good doctor always cures a disease that is not diseased, so there is no disease; a sage always cures a disease that is not diseased, so there is no disease." Yin calms yang secrets, and the spirit is the cure. If the yin and yang are unbalanced, the healthy balance will be broken, and obvious clinical symptoms will appear in sub-healthy hemorrhoids. Therefore, active and active health control interventions, pay attention to life, work, diet and daily life, take positive measures to respond, be optimistic, work and rest, do not sit for a long time; daily life, reasonable diet, do not eat spicy and stimulating Fishy food; develop good bowel habits, defecate regularly and quickly, do not squat for a long time, and read the newspaper while defecation; keep the anus partly clean, wash the anus with warm and cool water after defecation, and avoid repeatedly wiping the anus with toilet paper. These measures can effectively prevent the transformation of hemorrhoids under sub-health state to hemorrhoids under disease state. In addition, exercise to strengthen the body and strengthen the ability to resist diseases. For example, Sui Chaoyuan’s "On the Sources of Diseases and Hemorrhoids" has a guiding method: "Step on the ground with one foot, bend the knees with one foot, hug the calf under the nose with both hands, and pull toward the body. In extreme situations, you can change the left and right sides for four or seven to remove hemorrhoids. This qigong guiding method can be practiced. The levator anus therapy can be performed at any time, 3 to 5 times a day, about 20 times each time; according to clinical verification, it can also kneel on the bed every night (knee-thoracic position). The effect is remarkable. The levator anus can promote the blood and lymph circulation in the anus, relieve and eliminate the fatigue and spasm of the anal sphincter, and can prevent the acute attack of sub-healthy hemorrhoids. For the three types of people who are most approachable to "sub-health", white-collar workers, college students, and partial eclipses should intervene and regulate hemorrhoids, not only to prevent hemorrhoid symptoms from onset, but also to eliminate other sub-health manifestations. Medical and social significance.

lidocaine for hemorrhoids,Frequent diarrhea

    Cheng Binbin, Department of Gastroenterology, Nanjing Hospital of Traditional Chinese Medicine:

    If you have loose stools or blood, check your stool routine. Do you have anal pain or discomfort? Hemorrhoids, anal fissures and other problems can also cause blood in the stool. During colonoscopy, the anal fissures may have healed.

    Appropriate TCM treatment and conditioning.

    Patient: Description of the condition (time of onset, main symptoms, hospital visits, etc.): Frequent diarrhea for nearly 4 years, abdominal pain during diarrhea, irregular stools, blisters when thin, and small when dry. Sometimes a little blood. I went to the state hospital for colonoscopy in 2008 and this year, and the doctors said that my intestines were fine. I have seen Chinese medicine and taken Chinese medicine. It has been better for a while, but the medicine has been discontinued in less than a month. Want to know what disease is? How can it be treated?

are hemorrhoids dangerous,Don't treat rectal cancer as hemorrhoids

    Rectal cancer and hemorrhoids are two completely different diseases. Rectal cancer or anal cancer is a malignant tumor. Clinical manifestations: changes in bowel habits, anal discomfort, falling sensation, blood in stool, abnormal stool shape, abdominal distension, abdominal pain.

    Since the incidence of hemorrhoids and rectal cancer is similar, when some symptoms of rectal cancer and anal cancer are overlapped or atypical, the clinical diagnosis of the two is often confused. The wrong diagnosis is not uncommon. Diagnosis of anorectal symptoms as hemorrhoids, Delay in the treatment of rectal cancer. Another error in the diagnosis is rectal cancer with symptoms of anal bleeding, misdiagnosed as hemorrhoids. Especially when the two coexist, the diagnosis and treatment of hemorrhoids can be satisfied after the examination finds hemorrhoids, and a comprehensive and correct diagnosis cannot be obtained for a long time. If a patient with the initial impression of hemorrhoids is carefully asked about the medical history and examined carefully, many diagnostic errors can be prevented.

    During my consultation in a hospital, I met a 49-year-old male patient who had bloody stools for four months. He was diagnosed with hemorrhoids in the local health unit and had hemorrhoid surgery. Because of no improvement, he went to another primary hospital for hemorrhoid embolization treatment, but it was still ineffective. The number of bowel movements increased from 3 to 4 times a day to more than 10 times. Finally, I recommend surgery. Postoperative pathological examination revealed rectal cancer.

    As mentioned above, differential diagnosis is very important. The examination method uses finger touch, rectalscope or sigmoidoscopy to find hard nodular masses or ulcers on the intestinal wall, narrowing of the intestinal cavity, blood and pus on the finger cuffs. Histological examination can confirm the diagnosis. X-ray barium enema is also very meaningful. If it is a female patient, if the lesion is located on the anterior wall of the rectum, an examination of the vagina and pelvis should be performed; if a male patient has symptoms of abnormal urination, an examination of the urethra and bladder should be performed to confirm whether the cancer has invaded these organs. In addition, a B-ultrasound examination should be performed to pay attention to whether there are tumors or ascites in the abdominal cavity, and whether there are metastases in the liver. Need to pay attention to whether the groin and supraclavicular lymph nodes are enlarged and whether there are metastases in the lungs. The best treatment for rectal cancer is surgery.

    I wonder if these answers will satisfy you? If your condition is still undiagnosed, you should go to a regular hospital for diagnosis as soon as possible to avoid delaying your condition.

hemorrhoids internal,Clinical symptoms of internal hemorrhoids

    ① Hematochezia: Painless, intermittent, bright red blood after the stool is its characteristics, and it is also a common symptom of internal hemorrhoids or mixed hemorrhoids in the early stage. Blood in the stool is mostly caused by fecal rubbing of the mucosa or excessive force of defecation, causing rupture and bleeding of dilated blood vessels. The mild cases usually have blood in the stool or stool, followed by dripping blood, the severe cases are jet-like bleeding, and the blood in the stool can often stop on its own after a few days. This has important implications for diagnosis. Constipation, hard stools, drinking alcohol and eating irritating foods are all triggers for bleeding. If bleeding is repeated for a long time, anemia may occur, which is not uncommon in clinical practice and should be differentiated from bleeding disorders.

    ② Hemorrhoids prolapse: It is often a late-stage symptom, usually with blood in the stool and then prolapse. Due to the enlargement of the hemorrhoids in the late stage, it gradually separates from the muscle layer and is pushed out of the anus during defecation. Mild cases only prolapse during defecation, and can recover on their own after defecation. In severe cases, it needs to be pushed back by hand. In more severe cases, prolapse out of the anus with a little abdominal pressure, or even coughing, walking, etc. Able to escape, difficult to recover, unable to participate in labor. A few patients complain that prolapse is the first symptom.

    ③Pain: Simple internal hemorrhoids have no pain, and a few have a feeling of falling and bulging. When internal hemorrhoids or mixed hemorrhoids are incarcerated, edema, infection, and necrosis appear, there will be varying degrees of pain (Figure 4).

    ④ Itching: Late internal hemorrhoids, prolapse of hemorrhoids, and anal sphincter relaxation, often secretion flows out, due to secretion stimulation, there are often itching and discomfort around the anus, and even skin eczema, the patient is extremely unwell.

are hemorrhoids hard,Precautions before anesthesia in anorectal department (intravenous anesthesia)

    Hello! Maybe you plan to do anorectal surgery such as hemorrhoids, anal fistula, anal fissure, perianal abscess, etc. Before the operation, you don't know much about the methods of anesthesia and the precautions for anesthesia, and you are afraid or worried about the operation and anesthesia. So let me talk to you about another commonly used anesthesia method in anorectal department-intravenous anesthesia (without intubation).

    Intravenous anesthesia refers to the method of intravenous injection, injecting drugs into the blood circulation, and inhibiting the central nervous system to produce anesthesia. After the anesthesia, the patient felt no pain, as if he was asleep. General intravenous intubation anesthesia is used for short operations or special inspection operations, such as painless gastroscopy, colonoscopy, painless artificial abortion, etc. It is suitable for low requirements for anesthesia, the duration is relatively short, and the pain is relatively small. The recovery time is also relatively fast. During anesthesia, blood pressure, electrocardiogram, blood oxygen and other monitoring, oxygen inhalation are required, and breathing should be controlled if necessary. At the same time, during the operation, the anesthesiologist will also monitor the condition and monitor the vital signs.

    Intravenous anesthesia has certain limitations, such as: poor muscle relaxation effect, large individual differences, metabolism affected by liver and kidney function, controllability is not as good as intravenous inhalation combined anesthesia (tracheal intubation), analgesic effect is not strong, so simple In anorectal surgery under intravenous anesthesia, due to insufficient intraoperative and postoperative analgesia, or because the anal sphincter cannot be completely relaxed, it is often necessary to increase anal local infiltration anesthesia to ensure the smooth progress of the operation. Compared with spinal anesthesia, more drugs are used for anesthesia. Therefore, it is currently mostly used for patients in anorectal department who are not suitable for spinal anesthesia, such as hematological diseases, oral anticoagulant patients, patients after lumbar spine surgery and low back pain.

    If you plan to undergo anorectal surgery assisted by intravenous anesthesia, please read this precaution carefully in advance and refer to it. I hope these contents can help you eliminate your doubts and complete the examination or surgery smoothly.

    Patients who apply for painless treatment or before intravenous anesthesia need to undergo pre-anaesthesia assessment;

    Before the anesthesia, drink for at least 6 hours and fast for 8 hours, accompanied by family members on the day of examination.

    Before anesthesia, the patient or family members should communicate with the anesthesiologist face to face, so that the anesthesiologist can fully understand the patient's medical history, and then have the right to decide whether to perform anesthesia according to the patient's physical condition. For patient safety, please bring your medical records and related examination reports on the day of the examination, and sign an anesthesia consent form.

    Do not conceal the condition (such as blood disease, diabetes, high blood pressure, history of surgery, history of pregnancy, history of unfasted water, vomiting/retention of the stomach, hematemesis, etc.) and actual conditions, otherwise it will cause serious consequences.

    The process of intravenous anesthesia and anorectal surgery: puncture and infusion to establish intravenous access → anesthesia → surgery → wake up → fully awake → sent to the ward, the whole process takes about 1-2 hours. During the whole process, the patient is asked to obey the arrangements of the medical staff to prevent accidents such as falls.

    Discharge criteria: The patient is conscious, has stable vital signs, can walk independently, and has no obvious discomfort. After the anorectal doctor checks the condition and allows him to be discharged, he can leave the hospital with someone accompanied.

    Two hours after the operation, you can drink a moderate amount of water. The principle of no gastrointestinal discomfort should be no more than 50 ml each time; no nausea or vomiting occurs 4 hours after the operation. You can eat general food. If you have other conditions, follow the doctor's advice.

    To leave the hospital, you must be accompanied by your family. Driving or riding a bicycle is prohibited. Please do not drive or perform delicate work within 24 hours after the anesthesia is over. Do not sign legal documents. Please do not drink alcohol on the same day.

    During the operation of the patient, family members are requested to wait in the waiting room so that the doctor and family members can contact at any time.

    I hope that through my introduction, you can dispel your doubts, relax, and cooperate with the anesthesiologist and surgeon to successfully complete the anesthesia and surgery and recover soon!

    Xiyuan Hospital, China Academy of Chinese Medical Sciences

    Anorectal Department Cao Weiwei

what does a hemorrhoids look like,What are the benefits of early activities after surgery? How to carry out early postoperative activities?

    What are the benefits of early activities after surgery?

    Early postoperative activities can promote the recovery of body function; promote deepening of breathing, facilitate lung expansion and discharge of secretions, prevent pulmonary complications; promote blood circulation, help wound healing, prevent thrombosis; promote gastrointestinal peristalsis , Prevent abdominal distension, constipation; promote the recovery of urination function, prevent urine retention.

    How to carry out early postoperative activities?

    Early activities can be divided into early bed rest activities and early wake-up activities. After waking up, you can take deep breaths, cough, turn over, and move your limbs. After the condition is stable, take a semi-recumbent position, and gradually sit on the edge of the bed. When the condition is good, you can do further wake-up activities. Walk slowly indoors first, then go for a walk as appropriate. Patients who are seriously ill, have complications and restricted activities, cannot get out of bed early, but they should still stay in bed.

what does a hemorrhoids look like,Blood in the stool must be checked for rectal cancer!

    In daily life, hemorrhoids and rectal cancer may have the same or similar symptoms (such as blood in the stool), which makes some patients relax their vigilance. In fact, the condition of blood in the stool and hemorrhoids in colorectal cancer is slightly different.

    Hemorrhoids can occur in people of any age, and patients with rectal cancer are mostly middle-aged or elderly. Hemorrhoid patients have blood in the stool, which is caused by scratching the affected area during defecation. Most of the blood drips with the stool, so it does not mix with the stool, and there is no mucus. The stool of patients with rectal cancer is often mixed with blood, mucus and pus, and the stool habits will change significantly.

    [Long-term constipation, one of the causes of colorectal cancer]

    Long-term constipation can lead to higher and higher concentrations of carcinogens remaining in the stool. Long-term contact of the intestinal wall with these carcinogens may be a predisposing factor for colorectal cancer. At the same time, constipation is also one of the manifestations of colorectal cancer. Because the descending colon on the left is stenosis, if the tumor is on this side, it will often be obstructed and cause constipation. The doctor can basically determine where the colorectal cancer is through consultation and digital examination.

    [Changes in bowel habits are also a sign of rectal cancer]

    Changes in bowel habits should not be taken lightly, which may be a precursor to rectal cancer. Changes in bowel movements include many aspects. For example, normal bowel movements are relatively dry, but they have suddenly become thinner or become dry in the past few days; in some people, the frequency of bowel movements has changed from once a day to two or three times, or vice versa. In short, if there is abdominal discomfort, pain, local lumps, tenesmus, stool characteristics and shape changes (from dry to thin, with mucus and blood, or stools are not shaped, thin and flat), that is, the bowel movement is not the same as the usual regularity. , You should go to the hospital for a specialist examination as soon as possible.

    [Prevention of rectal cancer requires a scientific attitude]

    In addition to regular colonoscopy screening, it is also important to emphasize that the diet must be healthy. It is forbidden to eat spiced foods, eat less pickled food, eat less glutinous rice food, eat less instant noodles and other industrial fried and puffed foods; develop a good life Habits, do not smoke, do not drink alcohol; pay close attention to changes in stool characteristics and bowel habits: when mucus, bloody stools, black stools, irregular stools, thinner stool notes, changes in stool and bowel habits, changes in bowel frequency, frequent diarrhea or When you have difficulty defecation and other symptoms, you must go to the hospital to see a doctor for examination.

hemorrhoids essential oils,PPH minimally invasive surgery for hemorrhoids

    Also known as "circumcision of hemorrhoids", this is a new technique based on the new understanding of the pathogenesis of hemorrhoids caused by anal pad disease. PPH surgery uses a special instrument called a "PPH stapler" to make a circular resection of the prolapsed rectal mucosa above the hemorrhoids. During the operation, first open the anus and suture the rectal mucosa about 4 cm above the dentate line (the junction between the rectum and anal canal), and then insert the PPH stapler into the anus. The stapler can tape the prolapsed mucosa It only takes about half an hour to remove it. Because the rectal mucosa above the dentate line is innervated by splanchnic nerves, the patient has almost no pain after the operation; and because the operation not only removes the rectal mucosal prolapse zone, but also blocks the terminal anastomotic branches of the arteries and veins of the rectum, eliminating The root cause of hemorrhoids has a very ideal therapeutic effect on internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, ring hemorrhoids, severe hemorrhoid prolapse, prolapse and so on. It has the characteristics of quick effect, quick recovery and no pain after operation.

    Scope of application

    It has a very ideal therapeutic effect on internal hemorrhoids, mixed hemorrhoids, ring hemorrhoids, severe hemorrhoid prolapse, prolapse and so on. Prolapsed hemorrhoids, namely hemorrhoids in stage Ⅱ, Ⅲ, and Ⅳ or mixed hemorrhoids with internal hemorrhoids, especially the hemorrhoids with a circle, are especially suitable for middle-aged and elderly people, white-collar workers who pay attention to efficiency, and those who have relapsed in traditional treatment, accompanied by light Patients with severe rectal prolapse and rectal mucosal prolapse.

    Principle of operation

    Use a special circular stapler to insert into the rectum through the anus, circularly excise the mucosa and submucosal tissues of the intestinal wall at the lower end of the rectum, and perform an anastomosis at the same time as the excision, so that the prolapsed anal cushion is lifted and the normal anatomical position of the anal cushion is restored. The "suspension" function cuts off the arterial blood branch supplying hemorrhoids at the same time, and plays a "cut-off" function, so as to achieve the goal of radical cure.

    Technical advantages

    1. Safety: There is no need to remove the anal cushion, and the normal function of the anus is preserved to the greatest extent to avoid complications such as anal stenosis and anal incontinence.

    2. Painless: Pull the hemorrhoids protruding from the anus back to the original position, and cut off the blood vessels that provide blood to the hemorrhoids, without damaging the perianal skin, so there is almost no pain after the operation.

    3. Small trauma and quick recovery: the circular stapling of the mucosa is a non-open wound, with less bleeding, eliminating the trouble of dressing change after surgery, and returning to normal life quickly.

    4. Scope of diagnosis and treatment: ring hemorrhoids, multivalve hemorrhoids, huge isolated hemorrhoids, internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, ring hemorrhoids, incarcerated hemorrhoids, rectal mucosal prolapse, prolapse, etc.

    5. Suitable target: Because of less damage, it is especially suitable for middle-aged and elderly people, white-collar workers who pay attention to efficiency, and those who have relapsed in traditional treatment, and patients with mild prolapse and rectal mucosal prolapse.

    Contraindications

    It is not recommended for pregnant women, children, intractable constipation, pelvic tumors, portal hypertension, Bu-Ca syndrome or those who cannot tolerate surgery.

    Contraindications for PPH surgery include:

    ● Abscess

    ● Gangrene

    ● Anal stenosis

    ● Full-thickness rectal prolapse

    In the presence of gangrene or infection, stapled hemorrhoidectomy is an absolute contraindication, because the operation cannot remove the source of infection, and cutting other tissue levels will cause pelvic abscess and fournier’s gangrene (necrotizing fasciitis). Since an anal expander (cad) cannot be inserted, anal stenosis is also a contraindication. Full-thickness rectal prolapse is not suitable for pph surgery.

what does a hemorrhoids look like,I hope the doctor can heal my illness

    Patient question: Disease: mole sore

    Condition description: Difficulty in stool after mole sore surgery

    Hope to provide help: ask the doctor to give me some treatment suggestions

    Department of the hospital visited: local small and medium hospital

    Luo Fudong, Department of Anorectal Medicine, Dujiangyan Hospital of Traditional Chinese Medicine, replied:

    You should communicate with the doctor in charge in time. Sometimes patients with hemorrhoids after hemorrhoids have difficulty in defecation due to various reasons. In addition to their own constipation, there are also factors such as postoperative wound pain and stimulation. So communicate with the doctor to solve it. You can use some laxatives. In addition, it is normal to have a small amount of bleeding before the wound after hemorrhoids hemorrhoids grows up. As long as there are not many, there is no need to be nervous.

what does a hemorrhoids look like,Reprinted A proven prescription for treating hemorrhoids: Yizi Decoction

    Yi Zi Tang is a famous prescription for treating anorectal diseases, named after the colon resembles the character "B". "The smell of medicine is not much, but the essence is the evidence", it is worth learning!

    "Yizitang" treats hemorrhoids

    "Yizitang" prescription is a proven prescription for the treatment of various hemorrhoids by Nanyang's in Japan. The original prescription consists of 1 gram of rhubarb, 5 grams of Bupleurum, 1.5 grams of cohosh, 2 grams of licorice, 3 grams of skullcap and 6 grams of angelica. The author uses this prescription to treat various hemorrhoids, generally taking 5~10 doses, you can receive the effect of pain relief, hemostasis, and hemorrhoids gradually adduction. Here is a case of medical records.

    Zhang, 56 years old, has been suffering from hemorrhoids for more than 10 years. He was painful and bleeding when he attacked. Western medicine diagnosed mixed hemorrhoids.

    Check: thin body, dark complexion, red tongue, thick yellow tongue coating. Hemorrhoids are prolapsed, the pain does not stop, the stool is dry and knotted, the blood comes out casually, the pulse sinks and the string is slow, and the pulse appears astringent.

    The syndrome is heat toxin stagnation, blood stagnation. It is suitable to clear away heat and detoxify, promote blood circulation and relieve pain. Use "Yizitang" plus or minus to take it.

    Recipe: 18 grams of Angelica, 15 grams of Bupleurum, 9 grams of Scutellaria baicalensis Georgi, 6 grams of cohosh, 12 grams of licorice, 9 grams of rhubarb (back part).

    Before one dose is finished, the stool will be smooth, the pain will ease and the bleeding will stop. The second dose of rhubarb was reduced to 3 grams, and after two more doses, the pain disappeared. Prolapsed hemorrhoids are also collected daily. After a follow-up for more than a year, I was given a repetition only because of a burden, and the prescription still took effect quickly.

    Note: This recipe of Angelica and blood can improve the blood flow, and has analgesic effect. The rest is a product for clearing heat, purging fire and detoxification, and the combination of Bupleurum and cohosh has the function of lifting, lifting and sinking, which can promote hemorrhoids. Adduction, raw rhubarb will relieve heat and lax, and smooth stool will avoid the risk of bleeding. The medicine does not smell much, but the essence is the evidence. It works quickly. If you can stop drinking and eat spicy, long standing, and overworked, it will not be easy to recur.

    This article is excerpted from "China Journal of Traditional Chinese Medicine"

2020年10月29日星期四

hemorrhoids home remedies,Who needs colonoscopy?

    Colonoscopy is the most important method for early detection of colorectal cancer. It inserts the colonoscope into the intestinal cavity through the anus to observe whether there are any lesions in the entire large intestine cavity. It can also clamp small pieces of lesion tissue for pathological examination, which is helpful To confirm the diagnosis and judge the severity of the disease, and then guide the treatment. In addition, colorectal polyps can be removed under colonoscopy, and bleeding can also be stopped under colonoscopy.

    Who needs a colonoscopy?

    (1) Those who have symptoms such as blood in the stool, melena, or long-term stool occult blood test is positive;

    (2) Those with mucus, pus and blood in stool;

    (3) People with frequent bowel movements, unformed stools, or diarrhea;

    (4) Those who have had difficulty in defecation or have irregular bowel movements recently;

    (5) Stool becomes thin and deformed;

    (6) People with long-term abdominal pain and bloating;

    (7) Unexplained weight loss or wasting;

    (8) People with unexplained anemia;

    (9) Abdominal masses of unknown cause, requiring a clear diagnosis;

    (10) Unexplained increase in CEA;

    (11) Long-term chronic constipation, who cannot be cured for a long time;

    (12) Chronic colitis, long-term medication, who does not heal for a long time;

    (13) Suspected colon tumor, but negative on barium enema X-ray examination;

    (14) CT or other examinations of the abdomen found thickening of the bowel wall, and colorectal cancer needs to be excluded.

    (15) Lower gastrointestinal bleeding, bleeding lesions can be found, the cause of bleeding can be determined, and endoscopic hemostasis can be treated if necessary.

    (16) Patients who have suffered from schistosomiasis, ulcerative colitis and other diseases.

    (17) Colonoscopy needs to be reviewed regularly after colorectal cancer surgery. Patients after colorectal cancer surgery generally need a colonoscopy every 6 months to 1 year. If the colonoscopy fails to examine all the colon due to colonic obstruction before the operation, colonoscopy should be performed 3 months after the operation to determine whether there are colon polyps or colon cancer in other parts.

    (18) Those who have been found to have colon polyps and need to be removed under colonoscopy;

    (19) Colonoscopy needs to be reviewed regularly after colorectal polyps. Colorectal polyps may recur after surgery and should be reviewed regularly. Villiform adenoma, serrated adenoma, and high-grade epithelioma polyps are prone to recurrence and cancer. It is recommended to review colonoscopy every 3-6 months. For other polyps, it is generally recommended to review the colonoscopy every 12 months. If the colonoscopy is negative after the recheck, recheck after 3 years.

    (20) People with a family history of colorectal cancer should undergo colonoscopy: if one person in the family has colorectal cancer, even if his immediate family members (parents, children, siblings) have no symptoms or discomfort, they should undergo a physical examination for colon Mirror inspection. A large number of studies have proved that if a person has colorectal cancer, the probability of his immediate family members (parents, children, siblings) getting colorectal cancer is 2-3 times that of the normal population. Many of the colorectal cancer patients treated in our department have parents who have colorectal cancer. After a few years, it was discovered that children, siblings and siblings had colorectal cancer again, so we should pay special attention.

    (21) People with a family history of colorectal polyps also need to undergo colonoscopy.

    (22) People over the age of 40, especially those who have a long-term high-protein and high-fat diet and long-term alcoholism, are best to undergo a colonoscopy routine physical examination to detect asymptomatic early colorectal cancer as soon as possible.

    Special Note!

    1. Blood in the stool ≠ hemorrhoids! The incidence of hemorrhoids is very high, and blood in the stool is the most common clinical manifestation of hemorrhoids, so many people think that blood in the stool is caused by hemorrhoids. This view is extremely wrong, because many other diseases can also cause blood in the stool, such as colon cancer, rectal cancer, anal fissure, and rectal hemangioma.

    2. Hematochezia is the most important clinical manifestation of colorectal cancer. At the same time, blood in the stool is also a common symptom of dozens of anorectal diseases such as hemorrhoids, anal fissure, and enteritis. Therefore, it is impossible to determine the true cause based on blood in the stool. When hematochezia or melena occurs repeatedly, go to a regular hospital for colonoscopy in time to avoid delay in diagnosis.

    3. Hemorrhoids will not cause rectal cancer, but hemorrhoids can be accompanied by rectal cancer at the same time. Hemorrhoids are a benign disease that will not evolve into rectal cancer, but patients who have hemorrhoids can also get rectal cancer. It should be taken seriously.

    4. Patients with hemorrhoids with blood in the stool should be highly suspected of rectal cancer. The main symptoms of hemorrhoids and rectal cancer are blood in the stool. Some patients have a history of hemorrhoids, so as long as they have blood in the stool, they are considered to be bleeding from hemorrhoids. The blood in the stool caused by rectal cancer will also get better after hemorrhoid suppository treatment, but after a period of time, the blood in the stool will appear again, and it will not heal for a long time. At this time, you should go to a regular hospital as soon as possible for digital rectal examination and colonoscopy to rule out the possibility of colorectal cancer.

what does a hemorrhoids look like,How can the wound heal as soon as possible?

    The anorectal department is a surgical department. Most patients are treated with surgery. The recovery of postoperative wounds is one of the keys to disease recovery. But why do some people recover quickly, while some people heal their wounds very slowly?

    One by one

    Normal healing time after anorectal surgery

    ▌ Hemorrhoids

    Under normal circumstances, after hemorrhoid surgery, it usually takes 7 to 10 days for the affected area to begin to grow flesh, and it takes about 30 days to heal. Different human constitutions also vary.

    ▌Anal fissure

    The recovery time after the operation depends on the patient's physique. The thread is hooked up during the operation. Generally, the thread will break by itself within 1 to 2 weeks, and then the dressing will be changed to promote wound healing. Usually, the symptoms will get better in about a month. A few people hang up the line for two weeks and can only be removed by a doctor, which may prolong the recovery time.

    ▌Anal fistula

    It can be divided into high anal fistula, low anal fistula and complex anal fistula. The low anal fistula usually takes about 30 days to heal after operation; while for high complex anal fistula, the general repair time takes about 50 days. During the recovery period, if the patient has symptoms such as eczema due to allergies to certain drugs, the healing of the wound will be delayed.

    ▌Perianal abscess

    Depending on the patient's own condition and the size of the abscess cavity, the recovery time is different. Small abscesses may take one to two weeks to heal, while large abscesses take about two to four weeks to heal. Generally speaking, the wound of perianal abscess does not heal for more than one month after surgery, which is considered to be poorly healed.

    One by one

    Don't let the postoperative recovery slow down

    Although everyone knows the normal healing time, why still a considerable number of patients cannot recover in time? Look at the following factors, which also allow us to get better guidance after surgery.

    ▌Age

    The older the age, the slower the wound healing. This is related to the systemic factors of the elderly

    ▌Nutrition

    The lack of protein, vitamins, and trace elements can not provide the nutrients needed for tissue regeneration and will delay wound healing. Trace elements related to wound healing include copper and zinc, and vitamins include vitamin A, vitamin C, and vitamin E. These substances are generally not deficient in normal human bodies.

    However, the need for wound healing is much greater than usual, and the patient’s poor appetite and less food will also cause demand. It is very important to strengthen nutritional support after surgery. Especially patients who can eat should eat a digestible high-protein and high-calorie diet.

    ▌Infection

    When the wound is infected, there are many exudates, which will open the healing wound or the sutured wound, or cause the infection to spread and aggravate the injury.

    ▌Local blood circulation

    On the one hand, local blood circulation ensures the oxygen and nutrients needed for tissue regeneration, on the other hand, it also plays an important role in the absorption of necrotic substances and the control of local infections. Therefore, proper activities are needed to promote blood circulation after surgery.

    ▌blood sugar

    Diabetes patients have more sugar in the blood and vascular disease, which can affect wound healing. Before and after surgery, blood sugar control will directly affect the degree of wound recovery.

    ▌Smoking

    The combination of carbon monoxide and hemoglobin in the blood circulation of smokers reduces the ability to transport oxygen. Nicotine will constrict peripheral blood vessels and affect wound healing.

    ▌Psychological factors

    Psychological stress affects the function of the neuroendocrine immune system and slows down wound healing.

    ▌Postoperative complications

    Complications such as thrombosis, pneumonia, peritonitis, postoperative intestinal obstruction, etc., have a direct impact on wound healing.

    ▌Drugs

    Immunosuppressants, cytostatics, and hormone anticoagulants have a direct negative impact on wounds, inhibit cell proliferation and affect tissue repair.

are hemorrhoids dangerous,Postoperative complications and countermeasures for anorectal diseases-(postoperative bleeding)

    Postoperative bleeding is divided into primary (bleeding within 24h after operation) and secondary bleeding (bleeding after 24h after operation).

    Cause:

    ①Unskilled operation; incomplete anesthesia, poor anus relaxation; inadequate exposure of the operation area, improper handling of bleeding areas, and incomplete ligation of active bleeding points, which may easily cause bleeding in the wound; ②The surgical wound is large and the dressing is not compressed Prison, causing bleeding from the wound after surgery;

    ③ After the operation, due to vigorous activity or defecation on the same day, it is easy to cause wound bleeding;

    ④The internal hemorrhoids are not tightly ligated or the ligation thread falls off or the internal hemorrhoids necrosis falls off, which can easily cause wound bleeding;

    ⑤Improper injection of internal hemorrhoids sclerosing agent, excessive concentration, excessive puncture, and deep injection site, which damages the blood vessels of the muscle layer;

    ⑥The patient suffers from hypertension, arteriosclerosis, cirrhosis of the liver and blood diseases, and coagulation mechanism disorders are all likely to cause postoperative bleeding.

    Top defense:

    ① Sufficient preoperative preparation. Ask about the medical history and perform a comprehensive physical examination. Do a good job of psychological care to relieve the tension of the patient. If coagulation dysfunction and bleeding tendency are found, non-surgical treatment should be used first, and surgery should be performed after the coagulation function is restored.

    ② Correct surgical operation. During the operation, clear anatomy and careful operation are required, and should not be rough.

    ③Perfect postoperative care. The patient should not relieve the stool within 24h after operation, and keep the stool unobstructed after 24h. Strictly prohibit all kinds of breath holding and increase abdominal pressure, avoid strenuous activities, eat light and easy to digest products, and do not drink alcohol.

    ④Intramuscular injection of carbachol (Anluoxue) or intravenous drip of phenolsulfonic acid (hemostatic sensitivity) or aminomethylbenzoic acid (hemostatic acid) and other hemostatic drugs.

    ⑤After the operation, take some drugs that moisturize the intestines and relieve the bowels to prevent induration of stool and bleeding from the surgical wound.

    treatment:

    ① After the operation, the bleeding of the wound can be suppressed with gelatin sponge, epinephrine cotton block or Yunnan Baiyao;

    ②For patients with primary hemorrhage, blurred wounds, unclear vision, and difficult to suture, give the bleeding wound injection 1:1 Xiaozhiling injection to stop bleeding;

    ③If the internal hemorrhoids are not tightly ligated or the ligation thread falls off, the ligation should be reinforced again. For postoperative bleeding caused by necrosis and shedding of internal hemorrhoids, the bleeding point should be found under anoscope, and then compression or ligation should be used to stop the bleeding.

what does a hemorrhoids look like,Middle-aged and elderly people need to be wary of "anal lock hemorrhoids"!

    1. What is anal lock anal hemorrhoids? What are the characteristics?

    Answer: Anorectal hemorrhoids are malignant tumors that occur in the anal canal and rectum. In the later stages of the disease, because of the narrow anus and difficulty in defecation, it is called anal hemorrhoids, which is equivalent to anorectal cancer in Western medicine. It is characterized by changes in bowel habits, deformed stools, blood in the stool, and abdominal pain.

    2. What causes the anal occlusion hemorrhoid?

    Answer: The occurrence of anal lock anus hemorrhoids is mostly caused by the normal loss of spleen and kidney, combined with anxiety and depression, spleen and stomach disharmony, endogenous dampness and heat, betting on the anus, accumulation of fire toxin, stagnation of qi and blood stasis, and swelling.

    3. What are the manifestations of anal lock anal hemorrhoids? What auxiliary examinations are needed?

    Answer: The manifestations of anal occlusion hemorrhoids: there are usually no obvious symptoms in the initial stage, and the disease progresses. It may appear: ① Blood in the stool-is the most common symptom of this disease. The initial blood color is bright red or dark red, not much, and often accompanied by it. Mucus is persistent. At the same time, there may be an increase in the number of stools, tenesmus, incomplete defecation, blood, pus, mucus in the stool, and a special smell. ②Change in bowel habits-another common early symptom of this disease, manifested as increased bowel movements, frequent bowel movements, but no stool discharge, sometimes constipation, and discomfort or falling feeling in the anus. ③Deformation of stool-In the later stage of the disease, the shape of stool becomes thin and flat, and signs of intestinal obstruction such as abdominal distension, abdominal pain, and hyperintestinal sounds appear. ④ Signs of metastasis-if it invades the bladder and urethra, there is poor urination and pain; if it invades the liver, hepatomegaly and jaundice may occur; if it invades the sacral nerve plexus, there may be severe and continuous pain in the rectum or sacrum. And radiate to the lower abdomen, waist or lower limbs. Late-stage patients may have symptoms such as loss of appetite, fatigue, anemia, and extreme weight loss.

    Digital rectal examination: Indurated masses or ulcers on the intestinal wall can be palpable, and the intestinal cavity is often narrowed. The finger cuffs are stained with blood, pus and mucous membranes, which have a special smell. Proctoscopy can see the range of lesions in the rectum, and a small piece of tissue can be clamped for pathological examination to confirm the diagnosis. Endoscopy can find no rectal disease on digital examination. Barium enema examination can find intestinal stenosis or incomplete barium shadow, which is helpful for diagnosis. The stool occult blood test was positive. CT, biopsy and other examinations are helpful for the diagnosis of this disease.

    4. How to treat anal lock anal hemorrhoids?

    Answer: After the diagnosis of anal occlusion hemorrhoids, it should be treated with early radical surgery, supplemented by Chinese medicine to improve symptoms, regulate the body's immune function, improve the quality of life, and help prolong survival.

    Internal governance

    Damp-heat accumulation syndrome: Anus bulge, increased stool frequency, bloody stool, dark red color, mucus in the stool, or diarrhea red and white, tenesmus, red tongue, yellow and greasy fur, slippery pulse; treatment is mainly to clear heat and remove dampness , Recipe uses Huaijiao Diyu Pills plus flavors: Sophora japonica, Diyu, Dihuang, Scutellaria, Nepeta, Citrus aurantium, Angelica, etc.

    Qi stagnation and blood stasis syndrome: perianal mass swelling, hard as a stone to touch, painful refusal to press, or bloody stool, dark purple color, tenesmus, difficulty in defecation, dark purple tongue, astringent pulse; treatment is to remove blood stasis, Mainly to clear away heat and detoxify, the prescriptions are Taohong Siwu Decoction and Shixiao San addition and subtraction: peach kernel, safflower, rehmannia glutinosa, peony, angelica, chuanxiong, wulingzhi, puhuang, etc.

    Qi and Yin Deficiency Syndrome: Difficulty defecation, blood in the stool, dark purple color, swollen anus, pale complexion, weight loss, fatigue, loose stools, with upset dry mouth, night sweats, red or crimson tongue, little moss, weak pulse or Breakdown; the main treatment is to replenish qi and nourish yin, clear away heat and detoxify, and use Sijunzi Decoction and Zengye Decoction as the prescriptions: ginseng, atractylodes, poria, licorice, scrophulariaceae, rehmannia glutinosa, and Ophiopogon japonicus.

    External governance:

    You can use Patrinia diffusa, Oldenlandia diffusa, etc., deep-fried and reserved enema, 2 times a day, 40ml each time. For local ulcers, Jiuhua ointment or Huanglian ointment can be applied externally.

    In the treatment of anal occlusion hemorrhoids, surgery should be performed early in order to seek a radical cure, combined with radiotherapy, chemotherapy, and traditional Chinese medicine treatment to improve the overall quality of life of the patient. Preoperative radiotherapy in advanced patients can improve local conditions. Chemotherapy combined with radical resection can improve the 5-year survival rate.

    5. How to prevent anal lock anal hemorrhoids?

    Answer: The preventive measures for anal lock anal hemorrhoids are: usually avoid high-fat diet, eat more fresh vegetables and fruits; daily life should be regular, work and rest, pay attention to exercise; do self-regulation, keep your mood comfortable, and keep your stool smooth To prevent the occurrence of constipation; actively treat anal lesions. Once anal discomfort, induration or bleeding, swelling and pain on the anal margin is found, it should be checked in time, as early as possible to detect and treat early; over 40 years old, changes in bowel habits and blood in the stool , Should be checked early.

hemorrhoids external causes,To prepare for the second child, remove hemorrhoids first!

    With the liberalization of the second-child policy, a large number of elderly pregnant women have emerged, and the troubles during pregnancy caused by this have also made these expectant mothers uneasy. According to statistics, the incidence of hemorrhoids in elderly pregnant women is as high as 80%. After pregnant women suffer from hemorrhoids, surgery is not recommended. It is best to take preventive care before pregnancy to avoid hemorrhoids during pregnancy. Regardless of the fact that hemorrhoids are a trivial matter, if hemorrhoids during pregnancy are not prevented in time, it will affect the health of the mother and fetus, and even affect the delivery process.

    Expert advice: To prepare for the second child, it is best to remove hemorrhoids first. Avoid hemorrhoids aggravated during pregnancy, leading to anemia, or even hemorrhoids incarcerated and necrotic, and emergency surgery will be necessary, which will cause adverse effects on pregnant women and fetuses!

    1. The dangers of hemorrhoids in pregnant women

    Pregnant women are a high incidence of hemorrhoids. With the growth of the fetus after pregnancy, the uterus gradually increases, which creates pressure on the inferior vena cava, which hinders the blood return in the pelvic cavity. The blood in the venous plexus around the anus is stagnant and tortuous. Hemorrhoids get worse.

    Long-term large amounts of blood in the stool can lead to insufficient maternal nutrition, weak physique, and developmental delay of the baby. For "pregnant mothers", curing hemorrhoids is a pre-pregnancy "compulsory course", not only to avoid the torture of hemorrhoids during pregnancy, but also to consider the health of the pregnant baby. During pregnancy, women are affected by symptoms such as blood in the stool, prolapse, pain, and itching of hemorrhoids, which can lead to anemia, dizziness, shortness of breath, fatigue, and poor spirits, which are not conducive to the development of the fetus, and even cause the fetus in severe cases. Miscarriage, premature delivery or other complications, there are many cases of fetal death in clinical.

    Anorectal health is important

    "Guoyu" Carbomer Hemorrhoid Gel: It is composed of Carbomer Gel, a variety of precious materials and a gel dispenser. The specific gel has a strong adsorption function, which can reduce inflammation, reduce swelling and relieve pain. It is used to relieve the symptoms of internal hemorrhoids, external hemorrhoids and mixed hemorrhoids caused by anal swelling pain, mucous membrane bleeding and constipation.

    Second, pregnant women are more likely to suffer from hemorrhoids

    1. After pregnancy, it can cause abdominal pressure to gradually increase. With the gradual increase of the uterus, the compression of the inferior vena cava is also increasing, especially when the fetal position is not correct, the compression is more obvious, directly affecting the veins of the lower rectum and anal canal The backflow of blood causes congestion and dilation of the hemorrhoidal veins and induces hemorrhoids.

    2. During pregnancy, on the one hand, the enlarged uterus compresses the intestine; on the other hand, women generally have less activity due to inconvenience during this period, the gastrointestinal peristalsis is significantly slowed down, and the stool stays in the intestinal cavity for a long time. , The water in the stool is absorbed excessively, causing dry stool, difficulty defecation and other symptoms of constipation. Dry feces can cause hemorrhoids to expand and expand to form hemorrhoids. In addition, dry and hard feces can easily scratch the hemorrhoidal mucosa and cause bleeding, and even cause the original hemorrhoids to detach from the anus and cause hemorrhoids incarceration, resulting in severe anus A series of symptoms such as pain and walking inconvenience.

    3. During pregnancy, hormone levels in the body have undergone further changes. The progesterone and relaxin in the female body will increase greatly, making the fibrous connective tissue in the body soft and elastic, causing water and sodium retention and vasodilation. This makes the hemorrhoidal veins more prone to congestion, varicose and enlargement.

    3. Prevention of hemorrhoids in pregnant women

    Reasonable diet: Pregnant women should be careful not to eat or eat less spicy food and condiments. At the same time, they should also develop the habit of drinking more water. It is best to drink light salt water or honey water. Pregnant women with constipation and hemorrhoids should consciously drink more water, eat more fruits and fresh vegetables. Especially vegetables and fruits rich in crude fiber. Eat less irritating foods such as chili, pepper, ginger, garlic, and green onions.

    Try to choose the left side sleeping position: when pregnant women adopt the left side sleeping position, it helps to avoid the enlarged pregnancy uterus from compressing the abdominal aorta, inferior vena cava and ureter, reducing the pressure on the rectal veins, and increasing uterine placental blood flow The amount of perfusion and renal blood flow are more conducive to the growth and development of the fetus and prevent pregnancy complications such as hemorrhoids and supine syndrome during pregnancy, and reduce the morbidity and mortality of pregnant women and fetuses during the perinatal period. Of course, in a long sleep, it is impossible to maintain a posture, you can alternate left and right, but it is best to take the left lying position.

    Appropriate exercise: Pregnant women should not sit for a long time, and should exercise appropriately to promote blood return to the anorectal area. Do 10-30 levator movements every day (that is, consciously contract the anus). This can reduce the congestion of the hemorrhoidal venous plexus, improve local blood circulation, and reduce the incidence.

    Prevent constipation and diarrhea: Do not bear bowel movements for a long time, develop regular bowel habits, do not read books and newspapers in the toilet during defecation, avoid prolonged squatting in the toilet, prolonged squatting can easily cause dilatation or varicose of the anal veins, so as not to stimulate the anus. , The time for squatting in the toilet is generally no more than 10 minutes. If you can’t get it out at a time, you can get up and rest for a while. When it’s difficult to defecate, you can use some laxative drugs, such as Maren Runchang pills, fruit guide tablets, etc. Laxatives are not suitable, let alone pressure enema, etc. Method to lax, so as not to cause miscarriage or premature delivery.

    Expert advice: To prepare for the second child, it is best to remove hemorrhoids first. Avoid hemorrhoids aggravated during pregnancy, leading to anemia, or even hemorrhoids incarcerated and necrotic, and emergency surgery will be necessary, which will cause adverse effects on pregnant women and fetuses!

    Q: What are the complications of anorectal disease?

    A: It is easy to cause some anal diseases: the stool is too hard, leading to increased abdominal pressure, making blood circulation in the anal veins unsmooth, anal fissure, hemorrhoids, rectal prolapse, blood in the stool, and difficulty in stool.

    Q: What should I pay attention to for anorectal diseases?

    A: Mainly soften stools. 1. Eat more vegetables with high fiber content. Potatoes (stewed), pumpkin, leeks, celery, spinach, etc. can be a cup of honey water before going to bed, and more honey. Drink a large glass of warm water after getting up in the morning (drink it all in one breath). Eat two bananas 1 hour after dinner

hemorrhoids lidocaine,"Beijing Evening News" published Chief Physician Fan Xueshun answering patients' questions.

    Li from Xi'an asked: I have had hemorrhoids for more than ten years. Once I fell ill, I used some topical medicine or sitz bath to relieve it. Recently, not only has it recurs frequently, but it is also more serious. At present, besides taking antihypertensive drugs, I also take aspirin for a long time. I heard that surgery for hemorrhoids is effective, but when I went to the hospital, the doctor said that I cannot be operated on in this case. Why is this?

    First, patients with liver cirrhosis are not suitable for surgery, because liver cirrhosis hinders the venous return of hemorrhoids, and hemorrhoids and varicose veins aggravate. Even with surgery, the effect will not be very good.

    Second, patients who take anticoagulants for a long time or those who take thrombolytic drugs for heart surgery should not receive surgical treatment for the time being, because anticoagulants can cause more bleeding on the wound.

    Third, patients with severe hypertension, diabetes, heart disease, kidney failure, blood disease, or long-term oral hormones due to certain diseases should be conservative and not suitable for surgical treatment.

    Patients who are undergoing radiotherapy and chemotherapy after cancer surgery should not undergo immediate surgery. Conservative treatment is recommended for pregnant women, elderly patients, and those with poor lung function.

hemorrhoids essential oils,Dr. Liu Fuyingcong's operation: high-frequency electrosurgical treatment of male severe circular mixed hemorrhoids!

    Doctor Liu Fuyingcong led the case

    Patient: Male, 45 years old, from Meishan City, Sichuan

    Main complaint: anal mass prolapsed with blood in the stool for more than 10 years, and worsened by 3 months.

    Specialty status: (lithotomy position) prolapsed annular hemorrhoids can be seen at the anal margin, the size of the wound is 4*3.5, soft, and can be pushed, and hemorrhoid nodules can be seen on the upper circle of the inner tooth line of the anal canal, especially at 1-4 points, 7 Significantly at -11 o'clock, with obvious mucosal erosion and bleeding.

    Diagnosis: circular mixed hemorrhoids with internal hemorrhoid bleeding

    Surgeon: Chief surgeon: Liu Fuyingcong, First assistant: Dr. Wang Tingting

    Operation method: Original plan: External stripping and internal ligation of circular mixed hemorrhoids, injection of internal hemorrhoid stump sclerosing agent; because the anal marginal incision and internal hemorrhoid erosion were found to have significant bleeding during the operation, the hemorrhoids were gently clamped and the hemorrhoids were found to be bleeding. High frequency electrosurgical surgery.

    Anesthesia: Caudal block anesthesia + basic anesthesia

hemorrhoids symptoms,How does anal fistula form? Symptoms of anal fistula? How is anal fistula treated? Does it recur after surgery?

    Anorectal fistula is a granulomatous tube connecting the anal canal or rectum to the perianal skin. It mainly invades the anal canal and rarely involves the rectum. Therefore, it is often called anal fistula. The inner mouth is mostly located near the dentate line and the outer mouth is located in the perianal skin. Place. The entire wall of the fistula is composed of thickened fibrous tissue, with a layer of granulation tissue inside, which does not heal for a long time. The incidence is second only to hemorrhoids, and is more common in young men. It may be related to the strong secretion of sebaceous glands, one of the target organs of sex hormones in men. Anal fistula is not self-healing advice or it is the key to go to a professional hospital for examination and treatment in time

    Anal fistula-overview

    Anal fistula refers to the granulomatous duct around the anus, which consists of three parts: the inner mouth, the fistula, and the outer mouth. The internal orifice is often located in the lower rectum or anal canal, mostly one; the external orifice is on the perianal skin, which can be one or more, which is unhealed or intermittently recurrent. It is one of the common rectal and anal canal diseases, any age It can be affected, and it is more common in young men. The incidence is second only to hemorrhoids, and is more common in young men. It may be related to the strong secretion of sebaceous glands, one of the target organs of sex hormones in men.

    Anal fistula-cause

    Most anal fistulas are formed by rupture of anorectal abscess or after incision and drainage. The abscess gradually shrinks, but the contents of the intestine continue to enter the abscess cavity. In the process of healing and shrinking, a tortuous cavity is often formed, and it is not easy to heal due to poor drainage. There will be many scar tissues around the cavity after a long time, forming a chronic infectious duct . Walking near the internal and external sphincter, the skin of the external mouth grows faster, often with false healing, causing recurrent attacks. Most of the infections of the pipeline are purulent infections, and a few are tuberculosis.

    1. Abscesses around the anorectum are often ruptured or cut outside the anus, and pus flows out from the outside mouth, but the primary infection is mostly in the anal sinus. The anal sinus is the gateway to secondary infections, repeated infections, forming a fistula.

    2. The fistula usually passes between the anal sphincter. Because the sphincter constantly contracts and relaxes, it compresses the fistula and affects the elimination of pus. It is prone to pus infection and difficult to heal.

    3. There is a certain amount of pressure in the rectum. Infectious materials such as feces and gas in the rectum can often enter the fistula from the internal opening, irritating the cavity wall, and being discharged from the external opening after secondary infection. This is also the cause of the fistula.

    4. After the anorectal abscess ruptures, the pus is discharged, the abscess cavity gradually shrinks, and the external ulcer and incision also shrink. The cavity wall forms a hard duct wall with connective tissue hyperplasia, so it cannot be closed naturally.

    5. The fistula is curved, or there are sinuses or branches, the drainage is not smooth, pus is retained, and repeated infections make the fistula difficult to heal.

    6. Poor anal venous return, frequent local congestion, malnutrition of tissues, and affect healing.

    7. Abscesses caused by tuberculosis, actinomycetes and other infections, Crohn's disease, etc. are difficult to heal on their own and form specific anal fistulas.

    Anal fistula-the cause of anal fistula recurrence

    1. Improper handling of anal glands: According to recent studies, anal gland infection is an important cause of anal fistula. Therefore, it is necessary to remove the internal mouth, as well as the anal glands and ducts with inflammation near the internal mouth.

    2. The location of the inner mouth is difficult to find: Sometimes the inner mouth cannot be accurately found, or the primary infection of the infection still remains in the inner mouth.

    3. Anal sinusitis: The complicated anal sinusitis is not treated in time, causing anal sinusitis to develop into anal fistula again.

    4. Newly formed anal fistula: Most patients have perianal abscess due to anal gland infection, which leads to a new anal fistula, which is mistaken as a recurrence. It is not difficult to distinguish in clinical practice.

    5. Complicated internal orifice: when there are two or more internal orifices in the fistula, the search for the internal orifice is incomplete, leading to recurrence.

    Anal fistula-harm

    1. Infected discharge

    One of the main symptoms of anal fistula is the discharge of pus or even fecal water after infection. It not only pollutes underwear, but also irritates the skin around the anus, causing obvious symptoms of anal itching, which makes the patient miserable, and also produces peculiar smell, which makes the patient There is a lot of embarrassment in public.

    2. Increased fistula

    If an anal fistula is not treated in time, it will recur, and the number of fistulas will continue to increase, and even fistulas will form in the anal sphincter space, which will evolve into a complex and intractable anal fistula, which brings great pain to the patient, even It will affect the normal physiological function of the patient's anus.

    3. Anal incontinence

    If an anal fistula is left untreated for a long time, it will cause serious and irreversible damage to the anal sphincter, causing patients to have varying degrees of anal incontinence, which will bring patients a lifetime of pain.

    Anal fistula-pathology

    Anal fistula

    Anal fistula has primary internal orifice, fistula, branch tube and secondary external orifice. The internal mouth is the entrance to the source of infection. It is mostly found in and near the anal sinus, on both sides of the posterior midline, but it can also be in the lower rectum or any part of the anal canal. Fistulas are straight and curved, and a few have branches. The outer mouth is the place where the abscess is ruptured or the incision and drainage site is mostly located in the skin around the anal canal. Because pathogenic bacteria continue to enter the duct through the inner mouth, and the duct tortuously walks around the inner and outer sphincter, the wall of the tube is composed of fibrous tissue and there are Granulation tissue, so it will not heal for a long time.

    Generally, simple anal fistulas have only one internal port and one external port. This type of anal fistula is the most common clinically. If the external opening is temporarily closed and the local drainage is not smooth, infection will gradually occur and an abscess will form again. The closed external opening can be pierced or another external opening can be formed elsewhere. Such repeated attacks may expand the scope of the disease or sometimes cause several external openings to communicate with the internal openings. This anal fistula is called a complex anal fistula, that is, there are one internal opening and multiple external openings. However, some people believe that complex anal fistulas should not be divided into the number of external openings, but refer to those whose main fistula involves the anorectal ring or above. Although this type of anal fistula has only one external port and one internal port, the treatment is more complicated, so it is called complex anal fistula. On the contrary, sometimes anal fistula has multiple external openings, but the treatment is not complicated.

    Anal fistula-classification

    Types of anal fistula

    1. According to the location, depth, height and number of fistulas and tracts, the classifications are:

    1. External fistula and internal fistula: There are at least two fistulas inside and outside, one is on the skin around the anus, most of which is 2 to 3 cm away from the anus, which is called the external opening, and the other is in the intestinal cavity, mostly at the tooth line The inside of the anal sinus is called the internal orifice. A few internal orifices are above the middental line and on the wall of the rectum. The internal opening of the internal fistula is the same as the external fistula, there is no wound, and 90% of the clinical findings are external fistulas.

    2. Low fistula and high fistula: The fistula is located below the plane of the anorectal ring as a low fistula, and above this plane is a high fistula [2]. The latter is related to the choice of treatment.

    3. Simple anal fistula and complex anal fistula: the former has only one fistula, the latter can have multiple fistulas and fistulas.

    Anatomical classification of anal fistula

    2. From the perspective of clinical treatment, the relationship between anal fistula and sphincter is more important, which can be divided into:

    1. Intersphincteric type-the most common type, the inner mouth is located on the tooth line, the fistula runs between the inner and outer sphincter, and the outer mouth is on the skin around the anus;

    2. Transsphincter type-the fistula penetrates the skin around the anus through the space between the external sphincter and the ischial anal canal;

    3. Suprasphincter type—uncommon. The fistula penetrates the levator ani muscle as above and penetrates the skin around the anus;

    4. Outer type of sphincter-rare, the inner mouth is on the dentinal wall of the rectum, the outer mouth is on the skin of the perianal distance, the fistula is outside the inner and outer sphincter, and goes down through the levator anus.

    Anal fistula-symptoms and signs

    Anal fistula is usually a perianal abscess that ruptures spontaneously or the wound does not heal for a long time after incision and draining the pus to form an external fistula.

    1. Clinical manifestations: A small amount of pus repeatedly flows out from the outer mouth of the fistula, which contaminates underwear; sometimes the pus irritates the perianal skin and causes itching. If the outer mouth is temporarily closed and pus accumulates, there will be swelling, pain, redness and swelling in the local area. The closed outer mouth can be pierced again, or another new outer mouth can be formed nearby. Such repeated attacks can form multiple outer mouths. Communicate with each other. If the fistula is drained smoothly, there will be no local pain, only slight swelling and discomfort, and patients often do not mind.

    2. Inspection: The outer mouth is a papillary protrusion or a bulge of granulation tissue, with a small amount of pus flowing out under pressure. Low anal fistulas often have only one outer mouth. If the location of the fistula is shallow, a hard cord can be felt under the skin. The outer mouth leads to the anal canal. The location of high anal fistula is often deep and it is not easy to touch the fistula, but there are often multiple external openings. Due to the stimulation of secretions, the perianal skin often thickens and redness. If there are external openings on the left and right sides of the anal canal, it should be considered as a "shoe-shaped" anal fistula. This is a special penetrating sphincter anal fistula, and also a high curved anal fistula. The fistula surrounds the anal canal and passes from one side of the ischiorectal fossa to the opposite side, forming a semi-circular shape like a shoe iron, hence the name. There is an inner mouth near the dentate line, and the number of outer mouths can be multiple, scattered on the left and right sides of the anus, in which there are many branches, spreading around. Shoe-shaped anal fistula is divided into two types: front shoe-shaped and back shoe-shaped. The latter is more common, because the back part of the anal canal is looser than the front part, and the infection is easy to spread.

    Anal fistula-common symptoms

    What are the common symptoms of anal fistula disease? In addition to prolapsed masses and lumps, what other common symptoms are there? [4]

    (1) The tumor prolapsed. A swelling prolapsed outside the anus after going to the toilet. Commonly seen in internal hemorrhoids, papilloma, rectal polyps, rectal prolapse and so on. It should be noted that the tumor that has protruded from the anus should be returned in time, otherwise it may cause the tumor to be incarcerated, difficult to repay, and cause pain and necrosis.

    (2) Lumps. The neoplasms or protrusions around the anus are common thrombotic external hemorrhoids, connective tissue external hemorrhoids, condyloma acuminatum, and anal squamous cell carcinoma.

    (3) Swelling. The swelling mentioned here mainly refers to perianal abscess and thrombotic external hemorrhoids. The swelling of perianal abscess is characterized by swelling, pain and throbbing, and often patients cannot straighten their waist. The swelling of thrombotic external hemorrhoids is limited to one point. Does not affect body position. Incarcerated internal hemorrhoids. The anal margin is edema due to the obstruction of blood return and lymph flow, and it is swollen like a blooming crystal "violet", with dentate lines visible in the middle and red hemorrhoid mucosa on or above it. In severe cases, it can be intensified to form a plug.

    (4) Secretions flow out of the anus. It can not only overflow from the fistula, but also from the anus, such as internal hemorrhoids, rectal prolapse caused by anal muscle relaxation, or overflow from the perianal skin, such as anal eczema. Clinical pus out of hemorrhoids and fistula. It is more common in anal fistula, abscess ulceration, inflammation of anal fissure, and proctitis.

    (5) Perianal itching. Itching and discomfort are mostly caused by irritation of the anus and surrounding skin. It is common in anorectal inflammatory lesions, skin diseases and enterobiasis. Severe itching, moist skin around the anus, and anal eczema for pimples; unbearable itching, thick and rough skin, lightening or darkening of the skin, it is anal pruritus; if it is more itchy at night. Sometimes small white worms are seen around the anus, which is anal enterobiasis.

    (6) Changes in bowel habits. Healthy people have normal bowel habits and changes in bowel habits are common in hemorrhoids, anal fistulas, anal fissures, and anorectal tumors.

    (7) Stool becomes thinner. Stool thinning is common in certain congenital diseases (such as congenital anorectal stenosis, anorectal lesions) or anorectal cancer. In addition, surgical injuries such as hemorrhoids, anal fistulas, and trauma can make stool thinner.

    (8) Abnormal stool. Any abnormalities in stool quality, volume, daily bowel movements, and bowel sensation are all abnormal stools. Many people usually think. Diarrhea and constipation are abnormal stools, in fact, this is only one aspect.

    In addition, if the stool contains mucus, bleeding, abdominal pain or bloating, as well as anal pain and itching, the occurrence, development, and relief are all related to defecation, and even cause and effect each other. Therefore, the above abnormalities can also be attributed in a broad sense. Abnormal stool.

    (9) Diarrhea. Patients often have more stools, thin or watery stool, and pus and blood in the stool. More common in dysentery and enteritis.

    (10) Constipation. Constipation is the most common symptom in patients with hemorrhoids, and it is a symptom that can occur in many diseases. Constipation refers to a decrease in the number of bowel movements, less than 2 to 3 times in 7 days, feces staying in the intestines for too long, too much water absorption, too dry and hard feces, which makes it difficult to discharge, which brings adverse effects on people's physical and mental health. It is not only the cause of hemorrhoid fistula and anorectal disease. It can also cause and aggravate many systemic diseases.

    Anal fistula-the distribution of fistulas

    There is a certain regularity in the distribution of the external and internal openings of anal fistula. Goodsall (1900) once proposed: draw a horizontal line in the middle of the anus. If the external opening of the anal fistula is in front of this line, the fistula often runs straight toward the anal canal, and the internal opening is located The corresponding position of the external opening; if the external opening is behind the horizontal line, the fistula is often curved, and the internal opening is mostly located in the middle of the anal canal. This is generally called Goodsall’s law. Most anal fistulas conform to the above rules, but there are exceptions. For example, the front high-shoe-shaped anal fistula may be curved, and the posterior low perianal abscess may be straight. Clinically, it has been observed that the straightness and curvature of anal fistula are not only related to the front and back of the anal canal, but also to the high and low positions of the anal fistula, and the distance between the external mouth and the anal margin. Cirocco (1992) once conducted a retrospective analysis of a group of anal fistula cases to test the accuracy of Goodsall's law in predicting anal fistula progression. He believed that this law was quite accurate in predicting the progression of anal fistula in the posterior external opening, especially for female patients, with 97% of internal openings. It is located in the posterior median anal crypt, but the prediction of the anal fistula of the anterior external mouth is not accurate. Only 49% of the radial fistulas conform to this rule, because Goodsall did not realize that 9% of the anterior anal fistula originated in the anterior median anal crypt.

    Anal fistula-development process

    Wuxi Kangtai experts pointed out that the formation of anal fistula is inseparable from the development of perianal abscess. The formation of anal fistula roughly goes through four stages:

    The first stage: infection and inflammation of anal crypts and anal flaps. At first, it is limited to local inflammation. If it is not treated in time, the inflammation can spread around the anus.

    The second stage: Inflammation starts from the local anal recesses and anal flaps, and gradually spreads to form peri-anorectitis. If the inflammation cannot be controlled, it may invade the tissue gaps with low disease resistance.

    The third stage: due to the decreased disease resistance of the tissues around the anorectal space, it becomes a place for germs to invade, spread, accumulate and multiply, causing the tissues here to be prone to infection and inflammation, which is invincible, and the formation of anorectal abscesses. If the anorectal abscess can be treated properly in the early stage, the abscess can often dissipate and heal without leaving sequelae; if the early treatment is delayed or improperly handled, the tissue necrotic pus can spread along the local space, making the condition aggravated and complicated.

    The fourth stage: After the perianal abscess ruptures spontaneously or is treated with incision, drainage and dressing, although the abscess cavity gradually shrinks, the ulcer does not close for a long time. At this time, the cavity wall has formed a hard duct wall with connective tissue hyperplasia, in the middle The remaining space is the fistula. The pus often flows out of the fistula, with repeated infections and recurring attacks. It cannot heal itself for a long time and becomes a fistula.

    Anal fistula-diagnosis

    1. Medical history The patient often has a history of perianal abscess or incision and drainage, and the wound has not healed for a long time.

    2. Clinical manifestations Repeatedly flowing out a small amount of pus through the fistula, perianal pus swelling and pain, perianal skin itching; pus outflow from the fistula when touched, hard cords can be palpable under the skin.

    3. Auxiliary examination The probe can be inserted into the pipe through the external port; methylene blue is injected through the external port, and the gauze in the anal canal is stained blue; fistula angiography can show the image of the pipe.

    Anal fistula-auxiliary examination

    1. Digital rectal examination: There is mild tenderness on the inside and outside of the mouth, and a few can be palpable to induration.

    2. Methylene blue dyeing method: stuff white wet gauze into the anal canal and the lower end of the rectum, and inject 1-2ml of methylene blue into the fistula through the external mouth, and then take out the gauze from the anal canal, according to whether there is methylene blue staining on the gauze and Stain the site to clarify the existence of the fistula and the location of the internal mouth.

    3. Probe inspection Use a probe to insert the pipe through the outer port to determine the location of the fistula and the inner port. This method is generally performed under anesthesia during the operation. If the operation is improper or unfamiliar with this method, it may cause false passages.

    4. Fistula angiography 30%-40% lipiodol is injected from the external mouth. X-ray film can be used to observe the distribution of fistula. It is mostly used for the diagnosis of high complex anal fistula and shoe-shaped anal fistula (Figure 6). Yang (1993) examined 17 cases of clinically suspected anorectal abscess or fistula, 6 cases of clinically suspected abscess, anal canal ultrasound AUS examination also showed abscesses; another 82% (9/11) AUS found fistula, but clinical Routine inspection failed to find.

    5. Anal canal ultrasound is sometimes valuable for the diagnosis of intersphincteric fistula, but it cannot diagnose external sphincteric fistula and transsphincteric fistula.

    6. MRI Lunniss reported 35 cases of the results of this method, the coincidence rates with the surgical results were: primary anal fistula (85.7%), secondary fistula and abscess (91.4%), hoof fistula (64.3%), fistula 80% of the inner mouth. Therefore, it is believed that the diagnosis of anal fistula position during MRI examination has extremely high accuracy. Correct use of MRI clinically can not only improve the success rate of surgery, but also monitor whether the complex anal fistula is completely healed.

    Anal fistula-differential diagnosis

    1. Perianal hidradenitis: This is the perianal skin disease that is most easily misdiagnosed as anal fistula, because its main feature is the formation of perianal abscesses and remaining sinus tracts. There are often bulges and pus in the sinus, and there are multiple external openings, so it is easy to be misdiagnosed as multiple anal fistulas or complex anal fistulas. The main point of identification is that the lesions of perianal hidradenitis suppurativa are in the skin and subcutaneous tissues. The lesions are extensive, and there may be numerous sinus openings, which are nodular or diffuse, but the sinuses are shallow and do not communicate with the rectum. After incision of the sinuses There is no pus, fistula, and no internal mouth. Wiltz reported 43 cases of perianal hidradenitis suppurativa, 35 cases were first diagnosed as anal fistula, Tibetan hair cyst, sinus and anal abscess, more than 6 years of medical history before diagnosis.

    2. Pelvic osteomyelitis: Pelvic osteomyelitis caused by pelvic purulent or tuberculosis lesions often occurs in the perineum sinus, which is very similar to the external opening of anal fistula. However, the former does not have an internal mouth, and X-ray shows that the pelvis is diseased.

    3. Anterior sacral fistula: The abscess between the sacrum and the rectum is punctured near the coccyx. The fistula is located in the sacral cavity. The external opening is often located on both sides of the tip of the coccyx. The probe can penetrate 8-10cm, and the fistula is parallel to the rectum.

    4. Sacrococcygeal Bone Tuberculosis: Slow onset, no acute inflammatory changes such as redness, swelling, heat and pain, thin pus will flow out after ulceration, the outer mouth is large, the edges are irregular, and it will not heal for a long time. X-ray film showed bone damage and tuberculosis foci in the sacrum.

    5. Sacrococcygeal teratoma: anterior coccygeal fistula or internal rectal fistula can be formed after rupture. Large teratomas can protrude from the sacrococcygeal area and are easy to diagnose; small asymptomatic tumors can be palpated behind the rectum and smooth, lobed masses. X-ray film shows a mass between the sacrum and the rectum, with irregular scattered calcification shadows, and bone or teeth.

    6. Advanced anorectal cancer: Anal fistula can form after ulceration, which is characterized by hard mass, pus and blood in secretion, and foul smell. Pathological sections can be diagnosed.

    Anal fistula-treatment options

    Schematic diagram of anal fistula thread therapy

    Once an anal fistula is formed, there is generally no possibility of self-healing, and surgical treatment is the only cure. However, in recent years, some people have used artificial materials to fill fistulas to treat anal fistulas. They believe that the effect is better and does not require surgical treatment. The principle of surgery is to cut or remove the fistula, making it an open wound and achieving the goal of gradual healing. The treatment should emphasize understanding the position of the internal mouth and the relationship with the deep part of the external sphincter to avoid damage to the sphincter and cause anal incontinence. There are several commonly used surgical methods [5].

    1. Fistula incision: It is suitable for simple low-position anal fistula. The probe is used to check the entire fistula during the operation, and all the fistula is cut through the probe, and the granulation tissue in the fistula is scraped to make the wound surface V-shaped. Fill the wound with oil gauze, and wash the wound with 1:5000 PP powder or hot water every day after 2 to 3 days. During the whole treatment process, care should be taken to ensure that the granulation tissue of the incision surface grows from the base to the superficial surface, and finally all heals. Therefore, it is very important to observe the wound surface and change the dressing frequently. The topical application of Shengji ointment or growth hormone preparation for 2 to 3 days after the operation can accelerate the healing of the wound.

    2. Thread-hanging therapy is suitable for high simple or complex anal fistula. This method can avoid postoperative anal incontinence caused by sphincter incision, rupture and contraction. It is widely used in clinical practice, easy to operate, and can be implemented in outpatient clinics. Its disadvantage is that the postoperative recurrence rate is relatively high, which is mainly related to the incomplete exploration of the branch and internal mouth by the surgeon. High complex anal fistula can be changed into a simple anal fistula after repeated threading. Operation method: Under anesthesia, first insert a probe from the outer port, pass the fistula through the inner port, tie a rubber band to the probe at the inner port, and then lead the rubber band from the inner port through the fistula to the outer port. Cut the skin between the inner and outer mouth and tighten the rubber band to ligate. The thread can be tightened again 3 to 5 days after surgery. Generally, the rubber band falls off within 2 weeks after surgery, leaving the open surface to heal gradually. If the rubber band does not fall off after 2 weeks, scissors can be used to cut the tissue bound by the rubber band.

    3. Anal fistula resection is generally applicable to low simple anal fistulas, but in recent years, many scholars have applied this method to high anal fistulas and complex anal fistulas. The method is to remove all the fistulas at one time, and the wound surface is healthy and normal tissue, with a small inside and large outside. Superficial wounds can be sutured in full thickness, and the stitches will be removed after 5 days. Most of them can be healed at first stage. Deeper wounds should be opened. When the high anal fistula is resected, the deep part of the external sphincter should be separated, and those who need to cut it should be sutured and reconstructed.

    Common dietary recipes for patients with anal fistula

    The occurrence of anal fistula is closely related to dampness and heat, so greasy foods that generate dampness and heat should be controlled, and at the same time, we should quit smoking, alcohol and tea addiction. Eat more light and vitamin-rich foods, such as wax gourd, loofah, mung bean, radish, etc.

    The long-lasting anal fistulas are mostly of the fictitious type, and the diet should be rich in protein and other foods, such as lean meat, beef, mushrooms, jujube, and sesame. In addition, foods for prevention and treatment of deficiency syndrome include fungus, yam, coriander, leeks, eggplant, ginseng, water chestnut, lotus root, fennel, lychee, chicken, mutton, figs, etc.

    Common diet therapy:

    1. 1 rice eel, 100 grams of lean pork, 25 grams of astragalus, stir-fry, add salt, sugar, and rice wine, and eat after removing the astragalus. It is suitable for patients with virtual anal fistula.

    2. Wash 100 grams each of rice and millet, add an appropriate amount of water to the pot and boil, wait until the porridge is half-cooked, add 500 grams of soy milk, stir well and cook, ready to eat. It is suitable for patients with futility, both young and old.

    3. 6 grams of chrysanthemum, 6 grams of white sugar, and 3 grams of green tea leaves, put in a teacup and brew with boiling water. It is slightly stuffy for a while, with a light fragrance and elegant, which can clear away heat and detoxify, promote blood circulation, remove dampness, and relieve anal fistula swelling and pain.

    Anal fistula-TCM treatment of anal fistula

    Indications of TCM treatment of anal fistula:

    It can be said that drug therapy looks dull in the face of anal fistula, and only surgery can make a big difference. However, some anal fistulas do not necessarily require surgery, and some patients are not suitable for surgery. Therefore, the traditional Chinese medicine treatment of anal fistula has its limitations. There are four scopes: first, patients with internal hemorrhoids and external hemorrhoids; second, elderly and weak people who are not suitable for surgery; third, the middle and late stages of internal and external hemorrhoids and other serious diseases. (Such as liver disease, kidney disease, abdominal tumors, etc.); fourth, anal fissure, anorectal abscess, fistula inflammation, and all anal infections at the beginning.

    What are the traditional Chinese medicine treatment methods for anal fistula?

    The treatment of anal fistula in Chinese medicine is mainly based on internal treatment, which can be summarized into the three principles of elimination, care, and supplementation, which can be used flexibly according to the severity of the disease. The specific decomposition is as follows.

    One: eliminate

    This is to use dissipating drugs to dissipate the initial perianal carbuncle and inflammatory external hemorrhoids, so as to avoid the pain of pus and incision. This method is suitable for diseases such as perianal carbuncle, inflammatory external hemorrhoids, thrombotic external hemorrhoids and anal fissure without pus. The specific usage depends on the nature of the disease. For those with evil expressions, the external should be resolved, those with solid inside should pass through the inside, those with accumulation of heat and toxins should clear away heat and detoxification, those with condensation of cold evil should be warmed, and those with stagnant qi should promote qi. Those with blood stasis should promote blood circulation and remove blood stasis.

    Two: support

    This is the use of medicines that nourish qi and blood to help the righteous qi and the leakage of poison, so as to prevent the poison from invading. This method is suitable for the middle stage of perianal abscess, weak righteousness, excessive toxins, inability to pass the toxin, perianal carbuncle flat and collapsed, loose roots and feet, and insufficiency of decay. If the poisonous qi is strong but the righteous qi is not weakened, pus-permeable drugs can be used to promote the early release of sepsis and reduce the pain and swelling, so as to prevent the sepsis from running around and causing future problems.

    Three: make up

    This is to use tonic drugs to restore righteousness, help regenerate the affected area, and make sores and fistulas heal as soon as possible. This method is suitable for the elderly with physical weakness, weak qi and blood, late ulcers, or after anorectal disease, heat toxins have gone, the lesions have been removed, and the mental fatigue, weak vitality, clear pus, and difficult sores, and Patients with blood in the stool and prolapse. Those with weak qi and blood should replenish qi and blood; those with weak spleen and stomach should manage the spleen and stomach; and those with insufficient liver and kidney should replenish liver and kidney. But when the poisonous evil is not exhausted, do not use the tonic method as early as possible to avoid the evil's internal connotation, which will cause trouble for a long time.

    Anal fistula-preventive measures

    1. Prevention and treatment of constipation and diarrhea are of great significance to the prevention of perianal abscess and anal fistula.

    2. Treat anal cryptitis and anal papillitis in time to avoid the development of perianal abscess and anal fistula.

    3. Actively treat systemic diseases that can cause perianal abscess, such as Crohn's disease, ulcerative colitis, and intestinal tuberculosis.

    4. If the anus is burning and uncomfortable, and there is a feeling of falling, it should be diagnosed and treated in time.

    5. Establish a normal life content (a balanced diet), develop good bowel habits, take a bath after defecation every day, and keep the anus clean, which has a positive effect on preventing infection.

    Diet after anal fistula operation

    Cocoa milk: half a catty of milk, 6 grams of cocoa powder, 10 grams of brown sugar, put the cocoa powder and brown sugar into the cup, flush the boiled milk into the cup, and then eat. Can be taken for a long time.

    Mung bean glutinous rice porridge: 50 grams of mung beans, 100 grams of glutinous rice, add appropriate amount of water and heat to cook the porridge[7] and then eat.

    Eel medicated diet: 2 eels, eviscerated, cooked with 2 cups of wine, 1 bowl of water, and eaten with salt and vinegar.

    Egg melon seed soup: 2 eggs, shelled, 30 grams of melon seeds, add 2 bowls of water, and serve with sugar.

    Spinach mixed with bean sprouts: 100 grams of spinach, 100 grams of vermicelli, 50 grams of bean sprouts, 10 grams of leeks, just cold.

    Anal fistula-how to determine the internal mouth of a complex anal fistula

    (1) Surgical examination, how to determine the internal orifice of complicated anal fistula? First, cut open the fistula and look for the internal opening along the fistula, which is generally easy to find.

    (2) Dyeing inspection. Put the dry gauze into the rectum. If it is stained, it proves that there is an internal mouth.

    (3) Probe examination, how to determine the internal orifice of complicated anal fistula? You can insert your finger into the anus first, and use a silver round-tip probe to gently probe into the intestinal cavity from the outer mouth along the pipe. Complete anal fistula. The finger in the intestinal cavity can touch the probe near the tooth line to determine the inner mouth. , Do not blindly use force when exploring, avoid false roads and spread the infection.

    (4) Anoscopy, all the teeth can be seen under direct vision. The internal mouth is often inflamed and inflamed anal fistula with secretions. The suspicious anal crypts can be probed with a silver round tip probe. [8]

    Anal fistula-cancerous anal fistula

    1. Causes of cancer

    1 Long-term chronic inflammation stimulation. The long-term existence of inflammation causes purulent secretions and feces to be discharged from the fistula, which stimulates the abnormal proliferation of tissue cells and leads to malignant lesions.

    2 Bacterial infection. Bacteria exist in the fistula for a long time, especially the infection of Pseudomonas aeruginosa or Mycobacterium tuberculosis, which can linger and cause cancer.

    Drug stimulation. The long-term and large-scale use of various topical drugs often stimulates the local area and causes cancer.

    2. The problem of cancer

    It can be explained clearly in three sentences

    1. Anal fistulas are not directly related to cancer. Anal fistulas are not the pre-cancerous lesions; 2. Chronic anal fistulas do have cancerous cases due to long-term inflammatory stimulation or scar tissue mutation; 3. Cases of chronic anal fistula cancers are very rare, and anal fistulas cancerous The probability is very low.

    Anal fistula as hemorrhoids hides great harm

    Both anal fistulas and hemorrhoids occur in the anus, and both have symptoms of pain and bleeding, so it is easy to treat anal fistulas as hemorrhoids. One of the main symptoms of hemorrhoids is prolapse of internal hemorrhoids. The internal hemorrhoids protruding outside the anus are clamped by the sphincter, venous return is blocked, and the arterial blood is still infused to increase the volume of the hemorrhoids, until the arterial blood vessels are compressed, thrombosis occurs, and the hemorrhoids become hard and painful and difficult to return Inside. Anal fistula is also a common anal disease. It can also be called hemorrhoids, which is the sequelae of ulceration and incision of abscesses around the anal canal and rectum.

hemorrhoids essential oils,Dr. Fu's micro-science popularization (2): Will blood in the stool be colorectal cancer?

    With the accelerated pace of modern life and changes in diet, work and rest habits, many office workers will encounter a frequent sympt...