2020年10月23日星期五

hemorrhoids bleeding treatment,Lecture 2: Differentiation of hemorrhoid bleeding and rectal cancer bleeding

    What are the key points for distinguishing hemorrhoid bleeding from rectal cancer bleeding?

    In clinical practice, when a patient has a small amount of blood in the stool, he thinks about whether he has an incurable disease. He is worried all day long. It is not relieved until the hospital is thoroughly checked. Then there is no difference between the two. This lecture will give you a brief summary. Introduction.

    Hemorrhoids are venous clusters formed by the varicose plexus of the lower rectum, anal canal and anal margin. They are "protruding" lesions of the human body. The essence of hemorrhoids is a vascular cluster. Therefore, the bleeding is mainly caused by various reasons (such as prolonged squatting, decreased immunity, long-term oral anticoagulants, drinking, spicy stimulation, etc.) caused by local damage to the vascular mass. Rectal cancer is a malignant tumor, an "abnormal tissue" of the human body. The essence of rectal cancer is tumor cells and small blood vessels that supply tumor cells. Therefore, the source of bleeding is mostly caused by cancer infiltrating the rectal mucosa to ulcerate the surface or the cancer itself.

    Features of blood in stool:

    Hemorrhoids blood in the stool is characterized by bleeding during or after defecation, and the color is bright red, as shown in the figure:

    Sometimes there is a small amount of blood attached to the surface of the stool or the toilet paper is stained red, sometimes it is dripping blood, and sometimes the blood is seen to be jet-like, and the bleeding stops after the stool. If long-term repeated bleeding or heavy bleeding, it can also cause anemia.

    The characteristic of rectal cancer bleeding is that blood is mixed with stool, and the blood in the stool is dark red, also called jam-like stool, as shown in the figure:

    Sometimes it's just blood stains on the surface of the stool. Blood in the stool is often mixed with stool, mucus, and pus, or occasionally with blood clots and necrotic tissue. Blood in the stool cannot stop by itself. The phenomenon of blood in the stool does not necessarily happen every time.

    Accompanying symptoms:

    In addition to blood in the stool, hemorrhoids have the following symptoms: ① Internal hemorrhoids prolapse: there is only blood in the stool in the early stage, but no prolapse; the hemorrhoids in the second stage are accompanied by defecation prolapse, and the hemorrhoids can be absorbed by themselves; It can come out with force or coughing. ②Pain: Internal hemorrhoids are generally painless. If the internal hemorrhoids are incarcerated (that is, they are stuck in the anus and cannot be received after prolapse), severe pain may occur. ③ Anal itching. Internal hemorrhoids above the third stage can cause damp itching around the anus due to sphincter relaxation and secretion in the intestinal cavity. ④ Anal bulge. Swollen hemorrhoids stimulate the rectal mucosa or inflammation of the hemorrhoidal mucosa surface, causing anal swelling.

    There are many symptoms associated with rectal cancer, the main symptoms are:

    ①Rectal irritation. Common diarrhea, tenesmus and incomplete defecation, sometimes defecation several times a day, but not much each time. Some patients may manifest as diarrhea and constipation alternately.

    ②Symptoms of cancer rupture and infection. Common stools contain pus, blood and mucus. Generally, the amount of bleeding is small, and the blood is bright red or slightly dark, attached to the surface of the stool, and the blood in the stool is often intermittent. In a few cases, massive bleeding may occur, and the patient feels uncomfortable with anal drop.

    ③Symptoms of intestinal stenosis and obstruction. Cancer infiltrates the intestinal wall and narrows the intestinal cavity, causing the stool to become thin and deformed. In severe cases, it will be difficult to defecate.

    ④Consumption signs. Long-term chronic consumption of malignant tumors can cause cachexia symptoms such as anemia and weight loss.

    ⑤ Signs of transfer. Rectal cancer is generally painless, but the cancer infiltrates the anal canal and sphincter, and the pain is significant. Malignant tumor cells can metastasize to other parts of the liver, such as the liver and lungs, along with the blood lymph. It can also directly infiltrate adjacent tissues, such as urethra, vagina, prostate, etc., to produce symptoms in corresponding parts. Attached pictures of rectal cancer:

    Age:

    Hemorrhoids can occur at any age, but the incidence increases with age. Rectal cancer tends to occur in middle-aged or elderly people.

    an examination :

    Differentiation of hemorrhoids from rectal cancer is mainly based on a doctor's examination. In general, digital anal examination is very important, because most hemorrhoids and rectal cancer occur in the parts that can be touched by the fingers. If you touch it with your fingers from the anus, you feel that there are soft protrusions inside, and the mucosal nodules with a smooth surface without tenderness are hemorrhoids. If you feel that there are hard cauliflower lumps with irregular shapes in the intestines, irregular edges and uneven surfaces, or ulcers with raised edges and central depressions, and you find that the intestinal cavity is so narrow that only one finger can be accommodated; after examination, the finger cot is stained with blood and mucus, It is very likely to have rectal cancer. Secondly, doctors need to use special inspection equipment, such as bell-mouth anoscope, electronic rectalscope, electronic fiber colonoscope, etc. These examinations require the patient to drain stool or even clean the intestines in order to distinguish whether hemorrhoids or tumors under direct vision.

    friendly reminder:

    If you have blood in your stool, you must not take it lightly, and you must go to a specialist for examination to rule out the possibility of rectal cancer. Even if the doctor knows the bleeding of hemorrhoids, if there is still blood in the stool after taking the medicine for a period of time, you should pay more attention to further examinations, so as to avoid the "cancer bleeding" being covered by the "hemorrhoid bleeding" and delay the treatment opportunity.

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