2020年10月26日星期一

hemorrhoids diagnosis,Diagnosis and treatment of blood in the stool

    Hematochezia (hematochezia): blood comes out from the anus, or mixed with stool, or pure blood. It is generally believed that melena can occur when the amount of bleeding in the digestive tract is more than 50 ml. Because the iron in hemoglobin combines with sulfide in the intestine to produce iron sulfide, the stool is tarry black. People who vomit blood often have black stools.

    There are many causes of blood in the stool. Almost all gastrointestinal bleeding can cause blood in the stool, but the common causes are: ① Upper gastrointestinal bleeding (see hematemesis). ②Small intestinal bleeding, such as intestinal tuberculosis, localized enteritis, acute hemorrhagic necrotizing enteritis, small intestine tumors, intussusception, etc. ③ Colon bleeding, such as dysentery, ulcerative colitis, localized enteritis, colon cancer, etc. ④ Rectal bleeding, such as rectal cancer, rectal damage, hemorrhoids, anal fissure, etc. ⑤ Other diseases, such as various blood diseases, epidemic hemorrhagic fever, typhoid fever and paratyphoid fever, hookworm disease, vitamin deficiency, etc.

    The color of blood in the stool depends on the location and speed of the gastrointestinal bleeding. Upper gastrointestinal bleeding and small intestinal bleeding are mostly dark red or black stools, which are often shiny due to a thin layer of mucus on the surface. However, if the bleeding rate is faster, the amount of bleeding is large, and the bowel movement increases, the blood can appear dark red or bright red. When the colon and rectum bleed, because the blood stays in the intestine for a short time, bright red or bright red blood is often discharged. Bleeding in the right colon, the blood often mixes with the feces, which can cause "jam-like" bloody stools. Bleeding from the rectum and sigmoid colon, blood often adheres to the surface of the stool. Acute massive blood in the stool, patients may have acute hemorrhagic anemia and acute peripheral circulatory insufficiency. Diagnosis of hematochezia is based on medical history and physical examination data, but gastrointestinal endoscopy is the first choice. If necessary, X-ray barium contrast, radionuclide, angiography and other examinations can also be used to help diagnosis.

    TCM analysis

    The title of "Lingshu·The First Birth of All Diseases" is "Hou Xue"; "Treatise on Febrile Diseases" is called "Blood Blood"; "The Synopsis of the Golden Chamber" is called "Xia Xue". The names of "blood" and "near blood". Zhang Jingyue pointed out: "Blood in the stool comes from far away, and the distant one is in the small intestine or the kidney.... The blood comes in the bowel, it comes near, and the nearer is in the wide intestine or the anus. "Later physicians have the names of bloody turbidity, intestinal wind, and dirty poison. "The Key to Syndrome and Treatment" says: "Bright red serum is intestinal wind, and turbid and dark are dirty poison." "Introduction to Medicine" has blood in the stool that is powerful, and those who shoot as far as an arrow are called "blood arrows."

    This disease should be differentiated from diarrhea, pus and blood. Patients with dysentery, pus and blood, are mostly mixed with pus and blood, and have obvious abdominal pain, tenesmus and other manifestations, while this symptom is manifested by blood from falling down during stool without pus-like substances, and no obvious abdominal pain and tenesmus.

    Certificate name. Blood in the stool results in "Suwen·Another Theory of Yin and Yang": it is caused by damp heat, stagnation, poisoning invading the intestines and stomach, or wind and heat in the lower Jiao, and blood vessel damage. "Three Causes and One Disease Syndrome" Volume 9: "The patient has blood in his stool, which may be clear, muddy, fresh, or dark, or before the stool, or after the stool, or with the discharge,... …So it is called blood in the stool." "The Synopsis of the Golden Chamber" regards blood first and then blood as distant blood, and blood first and then near blood. Near blood is divided into intestinal wind and dirty poison. Later generations are classified according to the cause of the disease, and are divided into damp-heat blood in the stool, heat-accumulated blood in the stool, heat-toxin blood, damp-toxin blood, drunken blood in the stool, cold blood in the stool, intestinal blood in the intestines, blood in the infusion, etc. See each article for details. If the blood in the stool does not heal for a long time, it is mostly caused by the loss of visceral energy, or the loss of the liver due to chronic disease, the spleen deficiency can not take blood, and the kidney deficiency can not be fixed. The treatment is suitable for strengthening the body, or both removing evil and strengthening the body. For dysentery, see blood in the stool, see the dysentery article for details. This syndrome is found in peptic ulcer, acute infectious disease, blood disease, and colon, rectum, and anal diseases.

    Four precautions for diagnosis

    Common causes of blood in the stool are lower gastrointestinal diseases, systemic diseases and upper gastrointestinal diseases. Anal hemorrhoids, injuries, digestive tract inflammation, tumors, vascular disease, etc. are common causes of blood in the stool. Certain acute infectious diseases, intestinal parasitic diseases, blood and hematopoietic diseases, and vitamin deficiencies can also cause digestion. Road bleeding. The blood in the stool is also different for various reasons. Therefore, it is necessary to consider the patient's age, the characteristics of blood in the stool, the way and amount of bleeding, and the development process of the patient.

    1. Don't ask about age and gender

    Adult blood in the stool is mostly internal hemorrhoids, anal fissure, inflammatory bowel disease, etc. Internal hemorrhoid bleeding is more common in men, and anal fissure bleeding is more common in young women and constipation patients. Children with blood in the stool are mostly rectal polyps and intussusception. Familial polyposis occurs more often than in adolescence, and most of them are mucus and bloody stools. Hematochezia in middle-aged and elderly people should rule out colorectal cancer and colonic diverticulum.

    2. Avoid regardless of the characteristics of blood in the stool, the way of bleeding, the color and the amount of bleeding

    Different lesions and different types of diseases lead to different blood in the stool. The clinic must carefully ask and analyze the patient’s medical history, and pay attention to every link in order to quickly and accurately determine the cause and location of the lesion, and make the examination more Targeted.If internal hemorrhoids bleeding is in the form of drips or jets; anal fissures are blood attached to the surface of the stool or stained with toilet paper. The amount of bleeding is small. If there is more bleeding, the blood is stored in the intestinal cavity. It may appear black, dark red or when discharged. There are blood clots; mixed blood in the stool is more common in the upper colon; blood color is dark red, mucus blood in stool, pus and blood in stool often indicate inflammation of the large intestine, more common in ulcerative colitis, dysentery, colorectal polyps, amoebic enteropathy, etc., and can also be seen in Colon cancer; upper gastrointestinal bleeding is generally tarry black stool, but when the amount of bleeding is more than 1000ml, the discharge is faster, and when it is discharged about 4 hours, it will appear dark red, or even brighter bloody stool. A small amount of blood in the stool generally comes from anal, rectal, and sigmoid diseases such as internal hemorrhoids, anal fissures, polyps, tumors, etc.; large amounts of blood in the stool are more common in upper gastrointestinal bleeding, acute hemorrhagic necrotizing colitis, large intestine hemangioma, colonic vasodilatation, and hemorrhoids Secondary bleeding after operation.

    3. Avoid asking about the occurrence and development of blood in the stool

    Blood in the stool of different diseases has its own characteristics. Internal hemorrhoids and anal fissures often bleed after stool; chronic non-specific colitis, colonic diverticulum, amoebic dysentery, colon polyposis, etc. often show repeated and intermittent small amounts of blood in the stool; advanced colorectal cancer may be persistent small amounts of blood in the stool. The blood in the stool of the above-mentioned lesions generally has a slower onset and a longer duration. Acute bacillary dysentery, hemorrhagic necrotizing colitis, intussusception and other blood in the stool are more rapid onset.

    4. Avoid considering the accompanying symptoms

    The concomitant symptoms of blood in the stool are of great significance to its diagnosis. Such as dysentery, rectal inflammation, rectal cancer, etc., blood in the stool is often accompanied by anal fall, tenesmus; internal hemorrhoids, polyps and blood in the stool have no anal pain; anal fissures are accompanied by anal pain and constipation; blood in the stool caused by anorectal injury has a recent history of injection or surgery ; Chronic non-specific colitis often accompanied by diarrhea, left lower abdominal pain; hemorrhagic necrotizing colitis, intussusception accompanied by severe abdominal pain; bacillary dysentery, epidemic hemorrhagic fever, leptospirosis, amoebic enteropathy She had a rapid onset, accompanied by fever and abdominal pain.

    Chinese treatment

    The terms "intestinal wind", "visceral toxin" and "yin formation" in Chinese medicine all refer to blood in the stool. Either blood first and then stool, or first stool and then blood, or simply bleeding. "Golden Chamber" has far blood and near blood. "Jingyue Quanshu" further clarifies that those with distant blood are either in the small intestine or the stomach; those with near blood are either in the large intestine or in the anus. In "Keys for Syndrome and Treatment", those with clear and fresh blood are regarded as intestinal wind, and those with turbid and dark are dirty poison. "Sanji Zonglu" said that the internal knot of yin qi is yin, and hemorrhoids are also included. There are two common causes of blood in the stool, one is that the spleen cannot control the blood, and the other is that the damp-heat bet damages the collaterals of the large intestine.

    In the syndrome of weak spleen, the blood quality is thin and the color is light, the dripping is constant, or the stool is dark and bloody, accompanied by poor complexion, tiredness and laziness, dizziness, tinnitus, faint abdominal pain, fever and cold, thin white coating or tooth marks . It belongs to spleen deficiency and weak qi, and dereliction of duty. Fang selected Huangtu Decoction, Guipi Decoction, Buzhong Yiqi Decoction, etc., avoid using the product of bitter cold injury, prevent ice and add frost. Medicines such as Taizi ginseng, Atractylodes macrocephala, tangerine peel, astragalus, Yunling, Zhaxintu, angelica, licorice, yam, raw corydalis, etc.

    Hot and humid bets, such as blood in the stool, such as fresh color, hot hands, feet, and dry throat, are heat pressing on the large intestine, hurting the blood network, and cooling blood to stop bleeding is recommended. Use Huaihuasan, Diyusan, Zhibai Dihuang Decoction, etc. Medicinal raw ulm, paeonol, raw land, locust flower, asparagus, Ophiopogon japonicus, scrophulariaceae, northern adenophora, bamboo leaves, honeysuckle, cornus, raw white peony, agrimony, etc.; if the blood is dirty and thick Large amount, poor stool, hot and astringent urine, mostly damp and hot large intestine. To clear away heat, remove dampness, and detoxify, often choose Diyu San plus atractylodes, phellodendron, and Zanglian pills, or use Alisma decoction plus dandelion, Guanzhong, Tuckahoe, Forsythia, rhubarb, etc. If the stool is bloody for a long time, the dampness and heat are not clear, and the Yingyin has been deficient, the treatment should take into account the deficiency and the actual, and the Yingqing heat.

    Hematochezia syndrome is common in many diseases. Clinically, we must first combine syndrome differentiation with disease differentiation, and be wary of malignant tumors. You should go to the hospital for examination and treatment to avoid delaying the opportunity.

    Common syndromes

    Excessive gastrointestinal heat: blood in the stool, dry lips, thirst and cold drink, swollen gums, bad breath, bitter mouth, sores on the tongue, constipation, anal burning, red tongue, yellow tongue, strong pulse, etc. .

    Damp heat and steaming: blood first, then defecate, red blood underneath, uncomfortable stool, swollen limbs, dull appetite, bitter mouth, short red urine, red tongue, yellow and greasy coating, pulse numbness.

    Deficiency and coldness of the spleen and stomach: blood in the stool first, or mixed blood in the stool, or pure blood, dark purple, or stool like tar, pale complexion, fatigue, abdominal pain, dullness, loose stools, cold limbs, mouth Light but not thirsty, pale tongue, white fur, weak pulse.

    Liver Yin Deficiency: Blood in the stool, symptom and dizziness, red and red cheeks, five upset hot, restless night sleep, bone steaming and night sweats, loss of sperm in dreams, backaches and limbs tired, body weight loss, red and crimson tongue, broken pulse .

    Hemorrhoids and blood in the stool: blood in the stool is bright red, pain in the anus is unbearable, or swollen with hemorrhoids, or accompanied by anal fissure, red tongue, yellow coating, and pulse strings.

    Female menstrual blood in the stool

    Some women have this symptom. Every time before menstruation or menstrual period, there will be symptoms of blood in the stool, but the blood in the stool gradually stops after menstruation. This happens every month and recurs. This situation is called menstrual blood in the stool. . Also called error or error. This symptom can be seen in what western medicine calls endometriosis. If you have hemorrhoids or ulcerative colitis, you may occasionally have blood in the stool during menstruation, but it is not necessary every month and is not periodic, so it does not belong to the category of blood in the stool.

    The most common syndrome type of blood in the stool is the gastrointestinal stagnation-heat syndrome. The cause of gastrointestinal stagnation and heat is mostly related to eating hot and spicy food or drinking alcohol freely, resulting in the accumulation of heat and evil. Therefore, "Yip's Bamboo Grove Female Branch" says: erroneous menstruation is caused by the accumulation of too much heat. From the analysis of the meridian theory, the stomach and the large intestine belong to the Yangming meridian, and the Chongmai connected with the uterus belongs to the Yangming meridian. Therefore, when menstruation is approaching or has come, the blood in the uterus is injected into the uterus, causing the qi of the Chongmai to become hyperactive, and the passage of the qi through the Yangming Meridian induces heat accumulation in the intestines, causing the blood collaterals in the intestine to be burned. , Resulting in blood in the stool. The clinical features of this type of syndrome are that blood in the stool usually occurs one or two days before menstruation, and the blood volume is large, and the blood color is deep red. Because the blood is lost to the back yin, the menstrual volume is reduced, the menstrual color is purple and the quality is sticky. It is also accompanied by flushing of cheeks, dry mouth and throat, dry stools, red tongue, yellow coating, slippery pulse and so on.

    The treatment of gastrointestinal stagnation-heat syndrome should adopt the principles of clearing the intestines, purging heat, cooling blood and stopping bleeding, and can choose Huaihua powder. Aiming at the main cause of gastrointestinal stagnation and heat, Sophora japonica is the main medicine to clear heat and cool blood, combined with Huanglian to clear gastrointestinal heat, and the two medicines work together to correct the original source of cleansing. Then use Danpi, Platycladus orientalis charcoal to cool the blood to stop bleeding, and stir-fried Nepeta to relieve wind and heat. The combination of the three medicines can strengthen the bleeding power. If there is a lot of blood in the stool, and the throat is dry and thirsty, adding Imperata cylindrica can not only cool blood and stop bleeding, but also clear heat and produce fluid.

    In addition to the gastrointestinal stagnation-heat syndrome, there are more common syndromes of yin deficiency, blood-heat and spleen failure.

    Yin deficiency and blood heat syndrome is more common in women with yin deficiency constitution. For example, chronic illness or repeated miscarriage, or melancholy, anger, and prolonged fire will lose energy in yin essence, leading to insufficient yin and blood. After menstrual cramps, yin deficiency is even better due to the bleeding of menstrual blood. Insufficiency of yin causes the fire to prosper, and the fire forces the blood to flow and overflow in the large intestine, thus causing blood in the stool. The characteristic of this type of syndrome is that blood in the stool occurs mostly during menstruation, and the blood volume is not much, dripping down, and the blood color is deep red. Since the pathogenesis is yin deficiency and blood heat, the menstrual flow is small and the color is dark. At the same time, it is accompanied by dizziness, five upset fever, hot flashes and night sweats, sore back and weak legs, red tongue with little coating, and detailed pulse. The treatment is to nourish yin, clear heat, cool blood to stop bleeding, and use Dabuyin Pills. The raw materials in the prescription, Radix Paeoniae Alba and Radix Adenophora nourishes yin, nourishes the kidney and softens the liver; Paeonol, Anemarrhena, Sophora japonicus, Sanguis sylvestris can purify the heat and stop bleeding. Nepeta clearing heat and dispersing intestinal wind, ebony yin and producing body fluid, the two medicines can strengthen the hemostatic effect after frying charcoal.

    The spleen disorder is often due to irregular diet, excessive fatigue, internal injuries of seven emotions, etc., resulting in damage to the spleen and stomach, and weakness in the qi. As soon as menstrual cramps occur, the qi will escape with the blood and cause qi deficiency, and qi deficiency will not be able to restrict the movement of blood, and blood in the stool will occur. Its characteristic is that blood in the stool is mostly during menstruation, and the volume is light. At the same time, the menstrual volume is heavy, the color is light and the quality is thin, accompanied by fatigue, lack of energy, lazy speech, palpitations, poor sleep soundness, poor appetite, loose stools, pale complexion, and pale tongue, thin and weak pulse. The treatment should adopt the method of invigorating the spleen and replenishing qi, warming the yang to stop bleeding, and choosing Huangtu Decoction. The focal heart soil in the recipe is also called Fulong Liver, which functions to warm the yang and invigorate the spleen, and cooperate with Astragalus and Atractylodes to nourish the vital energy and strengthen the function of the spleen and stomach. Strong spleen and stomach, self-control of blood. Donkey-hide gelatin and rehmannia glutinosa nourish blood and stop bleeding, thereby improving blood deficiency caused by blood loss. At the same time, use Scutellaria baicalensis Georgi to prevent the heart soil and astragalus from becoming too dry and damaging the yin fluid. As for roasted licorice, it can strengthen the temper when combined with Atractylodes macrocephala and Astragalus, and when combined with donkey-hide gelatin and Rehmannia glutinosa, it can replenish yin and blood. The whole prescription is strong and soft, and the compatibility is thoughtful. It is a special prescription for treating blood in the stool when the spleen does not control the blood.

    If there is a lot of bleeding, you can also add fried cohosh to lift the air.

    The above prescriptions should generally be taken 5 days before menstruation, if you think they are greeted, stop taking them until the second day of menstruation. Pills can be taken for one week after cleansing. For example, taking Diyu Huaijiao Pills for gastrointestinal stagnation and heat syndrome, 6 grams each, 2 times a day; taking Zhibai Dihuang Pills for Yin deficiency and blood heat syndrome, taking the same method as before; taking Ginseng Guipi pills for spleen failure to control the blood, the same method as before .

    Chinese medicine recommends that patients with blood in the stool should develop good eating habits in daily life, eat less spicy food, avoid smoking and alcohol, and avoid excessive fatigue and tension.

    8 "prescription taboos" for hematochezia treatment

    The key to treating hematochezia is to distinguish the severity of bleeding. In clinical treatment, attention should be paid to the following aspects:

    1. Contraindications for hemostasis treatment: Hemostasis is first considered in the treatment of hemorrhage in the stool, but hemostasis is not to blindly use systemic hemostatic drugs. Clinically, different hemostatic measures should be taken according to the cause, location, amount and speed of bleeding. Such as local drugs to stop bleeding, local surgery to stop bleeding and systemic drugs to stop bleeding. For mild local hemorrhage in the anus, local hemostasis is the main method; for severe hemorrhage, systemic hemostasis should be taken immediately and local surgical hemostasis measures should be taken.

    2. Contraindications for treatment of hemorrhoid bleeding: intermittent blood in the stool such as anal fissure, internal hemorrhoids, rectal polyps, etc., which have a slow onset and a small amount, and the effect of local application of cooling blood hemostatic drugs is better. When the amount of bleeding is large and the patient is unwilling to undergo surgery, hemostatic drugs can be used in conjunction with systemic administration.

    3. Contraindications for the treatment of infectious bowel disease: mucus, bloody stools, pus and bloody stools caused by chronic infectious bowel disease should be treated with comprehensive treatment for bowel disease. The bleeding cannot be simply stopped, otherwise the symptoms will not be cured, the inflammation will not be eliminated, and the symptoms will not be relieved. .

    4. Contraindications for postoperative injury treatment: primary or secondary hemorrhage after anorectal surgery, large amount, or massive hemorrhage, if the condition is urgent, local hemostatic measures should be taken immediately to find the bleeding point, ligation or compression to stop the bleeding, and at the same time With systemic application of hemostatic drugs, local and systemic treatments are performed simultaneously.

    5. Contraindications for the treatment of hematological diseases: hemorrhage in the stool caused by hematological diseases should be used for systemic hemostasis, with large doses, and local hemostatic treatment.

    6. The treatment of peptic ulcer bleeding is contraindicated in the treatment of gastrointestinal hemorrhage. Those who can not find the bleeding focus under the existing examination conditions should stop the bleeding in time. Black blood in the stool caused by upper gastrointestinal ulcers, in addition to routine hemostasis, must be acid-resistant to treat ulcers.

    7. Treatment taboos for patients with cardio-cerebral artery embolism: When patients with cardio-cerebral arteriosclerosis and cerebral embolism are combined with hematochezia, the application of hemostatic drugs must be timely and appropriate to avoid excessive hemostasis aggravating heart and brain diseases.

    8. Syndrome differentiation and treatment taboos: the treatment of blood in the stool should distinguish between cold and heat deficiency and excess, such as stool dripping or jet-like bleeding, blood is bright red, red tongue, thin white or thin yellow coating, floating pulse, it is blood under intestinal wind, treatment should be cooling blood To dispel wind and stop bleeding, add or subtract Liangxue Dihuang Decoction as a prescription; the stool is fresh and bloody, the volume is large, the mass in the anus is prolapsed, the anus is burning, or the stool is pus and blood, the anus falls, the lower abdomen pain, thin yellow coating, pulse string number, card It belongs to damp-heat betting, the treatment should be to clear heat, dry dampness and stop bleeding, and choose the addition and subtraction of Zanglian Pill; blood in the stool is dark, or accompanied by anal swelling and pain, or with abdominal pain, dark red tongue, white or yellow coating, astringent pulse, and stagnation of qi For blood stasis, the treatment should be to remove qi to dissipate blood stasis and stop bleeding, and use an anti-pain as a decoction to relieve the pain; if the stool is pale and thin, the complexion is less prosperous, the sense of fatigue is weak, the qi is lazy, the appetite is loose, the tongue is pale and there is Tooth marks, thin white fur, heavy pulse, the syndrome is spleen deficiency is not solid, qi subsidence, the treatment should be to invigorate the spleen and replenish qi, the prescription is to add or subtract Buzhong Yiqi Decoction.

    Beware of the six major complications of blood in the stool

    Many patients find that the symptoms of blood in the stool are often not alone, but often accompanied by other complications. If not treated in time, it will bring more pain to the patient and increase the difficulty of the treatment of blood in the stool. So what are the common complications of blood in the stool?

    1. Abdominal pain

    (1) Bloody stools or pus-blooded stools when lower abdominal pain occurs, and those who relieve abdominal pain after stool are more common in diseases such as bacillary dysentery, ulcerative colitis, and amoebic dysentery.

    (2) If you are an elderly person with a history of hypertension, coronary atherosclerosis, diabetes, and blood in the stool after abdominal pain, you should consider the possibility of ischemic bowel disease.

    (3) Chronic recurrent upper abdominal pain, periodic and rhythmic, and pain relief after bleeding, is seen in peptic ulcer.

    (4) Patients with epigastric colic or jaundice with blood in the stool should consider hepatic and biliary bleeding.

    (5) Abdominal pain with blood in the stool is also seen in acute hemorrhagic necrotizing enteritis, intussusception, mesenteric thrombosis or embolism.

    2. Tensile and heavy

    A feeling of heavy anus fall, which seems to be poor defecation and frequent defecation, but the amount of blood in each stool is very small, and there is no ease after defecation, which indicates anal and rectal disease, which is seen in dysentery, ulcerative colitis and rectal cancer.

    3. Fever

    Hematochezia with fever is common in infectious diseases or malignant tumors, such as sepsis, epidemic hemorrhagic fever, leptospirosis, gastric cancer, colon cancer, etc.

    4. Tendency to bleeding throughout the body

    Hematochezia with skin and mucosal bleeding can be seen in acute infectious diseases and blood diseases, such as leukemia, thrombocytopenic purpura or allergic purpura, hemophilia, etc.

    5. Skin changes

    For those with spider veins and liver palms, blood in the stool may be related to portal hypertension. Clusters of small purple or bright red capillaries appear on the skin and mucous membranes, suggesting that blood in the stool may be caused by hereditary hemorrhagic telangiectasia.

    6. Abdominal lumps, blood in the stool with abdominal lumps

    Consider colon cancer, intestinal tuberculosis, intussusception, Crohn's disease, and benign and malignant tumors of the small intestine.

    Autonomous Therapy

    1. Self-treatment

    (1) Yunnan Baiyao, 0.3 grams each time, 2-3 times a day. Swallow with warm water.

    (2) Piyue Maren Pills, 9 grams each time, 2 times a day, swallowed with warm water.

    (3) Zanglian pills, 9 grams each time, twice a day, swallowed with warm water.

    2. Proven prescription self therapy

    (1) Rhubarb charcoal powder, 3-6 grams each time, 2 times a day, swallowed with warm water.

    (2) Dry and ground eggplant leaf tiles, 6 grams each time, 2 times a day. Swallow the rice soup.

    (3) 60 grams of Eclipta prostrata, decoction instead of tea.

    (4) 15 grams of Diyu charcoal, 12 grams of Sophora japonica charcoal, 12 grams of madder charcoal, 30 grams of Chixiaodou, 10 grams of wind-breaking charcoal, 10 grams of rhubarb charcoal, and 10 grams of cork, 1 dose per day, divided into 2 times, decoction. It is used for patients with accumulated heat and dampness in the intestines, red and turbid blood, bitter mouth, thick yellow tongue coating, and poor stool.

    (5) 30 grams of stove heart soil, 10 grams of Codonopsis, 10 grams of Jiaobaizhu, 10 grams of ginger charcoal, 10 grams of cohosh charcoal, 12 grams of fried Qi, 9 grams of donkey-hide gelatin (separately), 6 grams of licorice, 1 stick per day , Decocted in 2 times. For those with weak temper, pale complexion, fatigue and weakness.

    3. Diet self-treatment.

    (1) 250 grams of pig large intestine, 15 grams of fresh Sophora japonica, cooking and soup.

    (2) Eat a few dried persimmons a day.

    (3) 10 grams of white fungus and 15 grams of red dates, stewed over low heat.

    (4) 30 grams of golden needle vegetable, brown sugar, decoction.

    (5) 15 grams each of ginger and mugwort. Decoction of Ai Ye with ginger, 1 cup per serving. Aiye Wenjing is used to stop bleeding and ginger to dispel cold. It is used for the treatment of bleeding due to deficiency and cold, and it is mainly used to treat bleeding after feces.

    (6) 5 bowls of vinegar and 3 bowls of adzuki beans, cooked and sun-dried for the end, each serving 5 grams. This prescription treats intestinal hemorrhoid blood.

    4. External self-treatment

    (1) Fumigation and washing. Ejiao is immersed in vinegar to soften it and then steamed to form a paste. Take 30 grams each time and then add 500 grams of vinegar to dissolve. After heating to boil, fumigate first and then wash the anus, twice a day. The stock solution can be washed many times. Used for anal fissure, hemorrhoid bleeding.

    (2) Applicator. Mix 2 sticks of bead yellow powder with cool oil, apply inside and outside the anus.

    (3) Wild wormwood (Artemisia cotyledon) is pounded like mud and applied to the anus.

    (4) Coat the anal mouth with egg and butter. (Suitable for dry and cracked anal mucosa.)

    Egg-butter preparation method; take a few cooked egg yolks, stir-fry in non-ferrous tableware on low heat, wait for the oil to seep out and filter.

    5. Other self-treatment

    (1) Rub the abdomen. Rub the abdomen twice a day in the morning and evening (after waking up before going to bed), counterclockwise 100 times each.

    (2) The levator. Retract the anus 2-3 times a day, 30-50 times each time.

    Avoid misdiagnosis

    In the past, there was no anorectal disease with sudden blood in the stool, or a small amount of dark red and turbid blood in the stool, which did not heal for a long time; or the blood in the stool contained necrotic and corrupt tissues and thick secretions. The patient should not be negligent and should go to the hospital for examination. For fear of pain caused by bowel movements, they endure bowel movements, which will cause constipation, endogenous heat toxins, and aggravate blood in the stool. Unmarried young women must pay attention to rest during menstruation and pay attention to the cleanliness of the genitals, otherwise it is easy to cause inflammation of the anal mucosa and rupture and bleeding.

    Other treatments for blood in the stool

    1. Diet therapy

    (1) Purslane Mung Bean Soup: 120 grams of fresh purslane (30 grams dried), 60 grams of mung beans, a total decoction and appropriate amount of brown sugar. Suitable for intestinal damp heat and blood in the stool.

    (2) Fotan mother tea: 30g fotan mother, 10g green tea, decocted the soup together, and served with sugar. Suitable for intestinal damp heat and blood in the stool.

    (3) Astragalus panax notoginseng boiled lean meat: Astragalus 30g, Panax notoginseng 10g, 5 jujubes, 150g pork lean meat, boil the soup and season with salt. It is suitable for spleen and stomach deficiency and blood in the stool.

    2. Preventive care

    Blood in the stool should pay attention to rest to avoid fatigue. The diet should be soft and rotten, less slag, easy to digest, and less irritating. Avoid tobacco, alcohol, and spicy food.

    Outpatient clinic you should see

    ·Anorectal Surgery: Patients who have bright red blood after defecation, or discharge bright red blood, and generally do not have severe abdominal pain, should go to anorectal surgery.

    ·General surgery: Patients with blood in the stool, severe abdominal pain or even shock should be referred for general surgery.

    ·Intestinal Clinic: Patients with acute onset and discharge of pus and blood should go to the intestinal clinic.

    Gastroenterology: Patients who have black stools, dark red bloody stools, or a history of chronic colitis, often discharge bright red bloody stools, should go to Gastroenterology.

    Hematology department: Those who have blood in the stool with a tendency to hemorrhage all over the body should go to the hematology department for further examination.

    ·Nephrology: If you have a history of nephritis and have bloody stools, you should go to the Department of Nephrology.

    ·Infectious department: Patients with blood in the stool after fever and life history in the epidemic area should be referred to the infectious department.

    Six elements of prevention

    (1) Develop the habit of defecation regularly, preferably in a thin paste state.

    (2) Reduce the posture that increases abdominal pressure, squat and hold your breath as follows. Avoid sedentary, long standing, long walking and overwork.

    (3) Avoid hot, greasy, rough, scumbag food, avoid tobacco, alcohol, and coffee.

    (4) Eat more foods with heat-clearing, nourishing, laxative and hemostatic effects, such as raw pear juice, lotus root juice, water chestnut juice, reed root juice, celery juice, carrots, white radish (cooked food), bitter gourd, eggplant, Cucumbers, spinach, golden needles, cabbage, egg yolks, apples, figs, bananas, black sesame seeds, walnuts, white fungus, etc.

    (5) Be cheerful and not get angry. The mood is not wide, irritability and depression will shrink the intestinal mucosa, and the blood will not flow smoothly.

    (6) Reduce intercourse. Excessive intercourse will congest the intestinal mucosa and increase bleeding.

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hemorrhoids essential oils,The procedure of hemorrhoid fistula surgery and precautions before and after surgery

    Hemorrhoid fistula surgery procedure and precautions before and after surgery     1. Come to the outpatient clinic every Monday or Wedn...