2020年10月26日星期一

lidocaine for hemorrhoids,Which patients with hematochezia should go to the hospital to check for bowel cancer?

    In my outpatient clinic, there are a lot of patients who seek treatment because of blood in the stool. Most of these patients are worried about whether they have bowel cancer. Of course, most of it is not bowel cancer, just worry about it. So, is there any relationship between blood in the stool and bowel cancer? Which blood in the stool should be highly alert to bowel cancer? Still need to be more popular science.

    1. Learn to distinguish the characteristics of blood in the stool

    It can be roughly distinguished from hemorrhoid bleeding or colon cancer bleeding from the characteristics of blood. In simple terms, the formation of hemorrhoids is caused by the varicose blood vessels in the anus. Because the hemorrhoids are very close to the anal orifice, even in the anal orifice, it will be manifested when the patient holds his breath before urinating. The anal sphincter contracts and squeezes. The pressure vessel ruptures, dripping or even spurting blood. After the stool, the anal sphincter reflexively contracts and drips again. The blood is discharged step by step with the stool. Therefore, the characteristics of hemorrhoid bleeding are: dripping or spraying of blood, separation of blood in the stool.

    Bleeding from bowel cancer is generally chronic bleeding from a tumor in the intestinal cavity. In most cases, the bleeding from the tumor is not sprayed or dripped, but mixed in the stool. It will not be bright red, but dark red, and the tumor is not only Ulcer bleeding, the ulcerated surface will also be infected secondary, inflammatory exudation, mucus appears, and the water will become red when the toilet is flushed. Therefore, the characteristics of blood in the stool of bowel cancer are: mucus dark red blood in the stool, mixed with blood in the stool.

    2. Analyze the cause of blood in the stool

    After the occurrence of blood in the stool, it is necessary to analyze whether there are any triggers. If it is caused by constipation or laborious defecation, it is fresh blood. Most of it is caused by hemorrhoids. If it is accompanied by pain, it may also have anal fissure. If there is no obvious inducement, accompanied by increased stool frequency, falling sensation, change in stool habits, or accompanied by abdominal distension, weight loss, etc., plus dark red stool, then you need to go to the hospital to rule out bowel cancer. In addition, some middle-aged and elderly patients usually take anticoagulants such as aspirin and warfarin because of cerebral infarction or heart disease, and a large amount of blood in the stool appears on one day. At this time, be aware of the possibility of bowel cancer and investigate in time. Because as mentioned earlier, bowel cancer is usually chronic blood loss, with a small amount and mixed in the stool, which is not easy to find. However, after long-term oral anticoagulants, the blood coagulation function and platelet aggregation become worse, which will cause more tumor bleeding.

    3. Be wary of high-risk groups of bowel cancer

    For patients over 40 years of age who need to be highly alert to the possibility of bowel cancer in the following situations, be sure to see a doctor in time: first-degree relatives have a history of colon and bowel cancer; have a history of intestinal polyps, adenomas or cancer; fecal occult blood continues to be positive; mucus, bloody stools, chronic History of constipation, chronic diarrhea, etc. For the above patients, if there is blood in the stool, they need to go to the hospital in time for physical examination and colonoscopy.

    About the Author:

    Shen Zhanlong

    Department of Gastrointestinal Surgery, Peking University People's Hospital

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