Our reporter Jiang Meiqin
During the May Day holiday, Mr. Guo ate a "big meal" for three days in a row, with big fish and meat, spicy and spicy. After the holidays, Mr. Guo suffered a lot. His buttocks were swollen and painful. He was neither sitting nor standing. Unlike the previous hemorrhoids, even pus came out in the end and he had to go to the hospital. After checking, the doctor told Mr. Guo that a fistula on his "butt" was purulent and he needed surgery.
Anal fistula is an unfamiliar term for many people, but in fact, it is a common and frequently-occurring disease in anorectal department. Some people may not know the disease themselves, or think it is a disease such as hemorrhoids and ignore the treatment. .
Anal fistula is abbreviated as anal fistula. It is an infectious tube connecting the anal canal and the rectum to the skin around the anus. Its inner mouth is mostly located near the dentate line (the dentate line where the anal canal and rectal mucosa join), and the outer mouth is on the skin around the anus. In layman's terms, it is like digging a well, or one or more tunnels, from the skin around the anus to the tissues around the anorectum. These channels often cause infection and even suppuration due to the entry of "fecal waste". If anal fistula is not actively treated, it will not heal for many years, causing great inconvenience and pain to the patient.
Hidden dangers of small cracks
Why is there such a "pipe" in the anal canal and rectum?
After most anal fistulas are ruptured by an abscess around the anorectal canal or after incision and drainage, the abscess cavity gradually shrinks, and the wall of the cavity will form a hard duct with connective tissue hyperplasia, which cannot be closed naturally. It can be said that perianal abscess is the early stage of anal fistula, and 99% of patients will turn into anal fistula after the abscess subsides. Once infected, anal fistula will recur. It is like a ramp on an expressway, which is a place with a high incidence of traffic accidents.
Sometimes when we defecate, the anus will split and bleed due to dry and hard stools. Although there is only a small amount of blood in the stool, it is such a small crack. If we are accidentally "drilled" by bacteria or foreign objects, it may cause Infection, suppuration, and abscess formation. When the abscess is ruptured or incised to drain the abscess, a cavity will be left to form a duct and become an anal fistula. Therefore, for such a small breach, we should not be careless. When it is time to seek medical treatment, we should still seek medical treatment in time, and do not delay into a more complicated and difficult disease. Don’t diagnose yourself blindly. It doesn’t matter if it is anal fissure or hemorrhoids.
On the other hand, good eating habits and bowel habits are also important methods to prevent anorectal diseases. In a sense, what is "imported" may determine the quality of "export".
Wetness, itching, pus, pain See a doctor promptly
Once an anal fistula is formed, the fistula is difficult to heal. If pathogenic bacteria or feces enter the fistula, it will cause repeated infection, suppuration, swelling, pain, and symptoms of systemic infection such as fever. Usually, a small amount of purulent, bloody or mucous secretions may flow from the fistula, and sometimes even a small amount of feces and gas may be discharged. Just like Mr. Gu, some patients found that they did not have a bowel movement, but there was feces flowing out, or traces of fecal contamination were seen on their underwear; they clearly did not fart, but they had gas as if they were farting. Moreover, due to the long-term irritation of the secretions, the anal area will be moist, itchy, and sometimes eczema will form.
A small number of patients may have no symptoms of discomfort, but accidentally touched an induration around the anus, which is not painful or itchy.
In clinical practice, many patients treat anal fistulas as hemorrhoids, and even buy ointments to treat hemorrhoids by themselves. The results can be imagined. Obviously, effective treatments are not available. On the contrary, the condition may be delayed or even worsen.
Therefore, when you find abnormalities such as moisture, itching, pus outflow, and pain around the anus, you should seek medical attention in time, and a specialist should check and determine what is causing the disease, so as to take corresponding effective treatment measures.
Treatment of anal fistula
At present, anal fistula can only be cured by surgery, that is, all the fistulas of the anal fistula are cut, and the growth of granulation tissue allows the wound to heal and grow well. Or use thread-hanging therapy to slowly "cut" the anal fistula. However, anal fistula surgery has difficult results.
Difficulty 1: Treating fistula and protecting the anus, striving for both
The difficulty of anal fistula surgery is not only to cure the disease, but also to protect the anal sphincter function. How to find a "balance point" between the two is one of the keys to testing the technical level of doctors. If the operation solves the problem of anal fistula, but destroys the function of the anal sphincter, leaving the patient with lifelong fecal incontinence and other abnormal bowel symptoms, wouldn’t it be worth the loss?
In clinical practice, after a patient has an anal fistula, the doctor tells him that the operation may cause abnormal bowel movements in the future, and even affect sexual function.
Difficulty 2: Break through each without leaving any future troubles.
Another difficulty of anal fistula surgery is that there may be more than one "pipe" and more than two fistulas. Many patients still have anal fistula recurrence after surgery, because some doctors can't find all the internal ostium during the operation, but only eliminate the surface fistula, but fail to solve the most critical internal ostium, or fail to remove all the fistulas. The removal of the "pipe" caused the anal fistula to occur repeatedly, and even multiple operations could not solve the problem and could not be cured.
In the movie "Tunnel War", underground passages extend in all directions like a maze. The same is true for anal fistulas. Although there are not as many channels as the maze, doctors have to block every channel in order to completely solve the problem and prevent the anal fistula from recurring. This requires doctors to practice a pair of "fire-eyed golden eyes", even the "Cunning Rabbit Three Caves" can be captured by hand, and each one can be defeated without leaving any future troubles.
Difficulty three: blind eyes, false healing.
Anal fistula will also play "eye-blocking method", a common problem after surgery is false healing, which is one of the main reasons for the unsatisfactory effect of anal fistula surgery. Usually, the outside of the wound has been glued after the operation, and part of the cavity may be formed on the inside due to dressing change or the patient's own reasons. It is usually necessary to pick up the tissues that have been pseudo-healed locally, and at the same time cooperate with a dressing change, so that the inside can heal as soon as possible.
It can be seen that how to choose the most suitable surgical method, how to avoid damaging the function of the surrounding tissues, how to completely cure the anal fistula to avoid recurrence, how to achieve the ideal surgical effect, etc., are all important for doctors and patients. Choice. The choice of doctors depends on their technical level, while the choice of patients depends on whether they choose the right professional doctors.
Have to go to "quiet work" after the operation
Anorectal surgery is somewhat fearful for many patients, and they are particularly worried about defecation problems after surgery. Surgery was performed on this area, and contact with dirt and water should have been avoided, so that the wound can heal faster. But the so-called eating and drinking Lazar, it is impossible for a person to put aside these four words while alive. So, what should I pay attention to in postoperative recovery? How to promote wound healing as soon as possible?
After anal fistula surgery, the length of time required for recovery is related to factors such as the severity of the disease and personal physique, but all need to go through a period of "quiet work" days. Although the operation is over, it will take some time for the original fistula to grow "meat" to fill these cavities. During this period, doctors often change dressings (about half a month), on the one hand to avoid wound infection, on the other hand, to promote wound healing. During this period of time, the patient should also avoid inappropriate exercise, otherwise the newly-grown wound may be damaged. This is not just a problem of pain. Prolonging the healing time of the wound is not only not conducive to postoperative recovery, but may also increase the risk of complications.
During dressing change, you should generally take a break and maintain a proper posture. Under the guidance of specialist doctors, according to the degree of recovery from the condition, gradually transition from lying position to sitting position, and then stand and walk until the wound is fully grown, and then you can live normally.
What needs to be reminded is that within a long period of time after the wound, do not rush to do various fitness exercises, take a proper rest, and perform mild exercises to avoid overwork, which is more beneficial to the recovery of the disease.
Eating and drinking during the recovery period "stool off"
After anorectal surgery, a problem that many patients worry about is the problem of defecation: Can you defecate smoothly? Will there be pain during defecation? How to reduce the pain during defecation? At this time, you have to pay attention to your diet. Follow the doctor's advice to eat a reasonable diet and maintain smooth stools, which can reduce pain.
First of all, there is no need to fast after anal fistula surgery, but at the beginning, liquid food or soft food should be given. Try to eat soft, digestible and nutritious food. Do not fast or eat very little because of fear of pain during defecation. Normal defecation stimulation can effectively contract and relax the anal sphincter and prevent anal stenosis.
Secondly, you can eat normally three days after the operation, but the diet should be light, fasting some spicy, stimulating, fried foods, such as chili, garlic, pepper, alcohol, fried chicken, fried fish, etc., eat less lamb, Dog meat, leeks and other foods that are easy to "get angry".
Finally, after the operation until the wound is healed, you should keep your stool smooth. You can eat more foods rich in vitamins and fiber, such as cabbage, broccoli, spinach, celery, radish, winter melon, pumpkin, kelp, apples, pears, etc. For vegetables and fruits, eat coarse grains rich in dietary fiber, such as millet, oats, buckwheat, black rice, corn, sweet potatoes, etc., and drink plenty of water. Reasonable eating habits can make stool softer and easier to pass through the intestines and anus, avoiding dry and hard stool friction and squeezing caused by the rectal and anal mucosa damage. At the same time, according to the condition of recovery, get out of bed in time when conditions permit, which can stimulate intestinal peristalsis and prevent constipation.
Anti-relapse life health care method
After recovering from anal fistula surgery, you can't hold on to the mentality of "good luck", and you still need to pay attention to preventive health care in your daily life to avoid recurrence.
Eat a reasonable diet and drink plenty of water
Patients with anal fistula pay more attention to the diet after the operation, but some patients "have their scars and forget the pain". After recovering from the disease, they start to have big fish and meat, spicy and thick taste, fried and stir-fried, which leads to constipation and even relapse. In fact, reasonable eating habits do not happen overnight, but should be adhered to for a long time, so as to keep healthy. To prevent the recurrence of anal fistula, you should eat more fresh vegetables and fruits in your usual diet, eat legumes and coarse grains, and drink plenty of water. Eat less spicy foods, eat less fried, smoked, and cured foods, and eat less hot foods such as lamb and dog meat.
Usually maintain a regular life schedule, take proper rest, combine work and rest, do not stay up late, avoid excessive fatigue, avoid standing for a long time, sitting for a long time, and at the same time, adhere to appropriate exercises to enhance physical fitness, improve immunity, and help prevent diseases. Patients with anorectal diseases can also do some levator anus exercises to promote blood circulation around the anus, enhance the contraction and relaxation of surrounding muscle tissues such as the anal sphincter and levator ani, and prevent anorectal diseases.
Sanitation and anti-infection
Around the anus is a place where bacteria are easy to grow and multiply. On the one hand, there may be pathogenic microorganisms in the excreted feces; on the other hand, the anus is directly connected to the outside world and may be exposed to certain pathogenic microorganisms. Therefore, the area around the anus needs to be kept clean and hygienic. It is necessary to clean it frequently and change underwear frequently to prevent local infection of pathogenic bacteria.
"Export" is smooth and healthy
People with frequent constipation and hard stools can easily damage the anal mucosa and become more susceptible to infection. For people with diarrhea, the stool may contain pathogenic microorganisms, and repeated stimulation of the anal sphincter may also injure the anus and anal canal. Therefore, preventing constipation and diarrhea is one of the important ways to maintain anorectal health. At the same time, it is necessary to actively prevent various anal diseases, such as anal cryptitis, anal papillitis, etc., to avoid the occurrence of perianal abscess and anal fistula.