2020年10月26日星期一

what does a hemorrhoids look like,Pain during defecation, be careful of "anal fissure"

    Many people in life experience pain in the anus during defecation, especially when there is no defecation for a few days, and the pain is particularly severe when the stool is particularly dry. Not only is it painful during defecation, it will continue to be painful for a long time after the defecation is over. Relief, sometimes accompanied by blood in the stool, most of them are blood on the toilet paper after defecation. Most people think that they have "hemorrhoids" and don't care. After some people have no more dry stools, the symptoms will automatically alleviate and disappear for a while, and many people have symptoms Not only does it not disappear, but it becomes more and more serious. Every time you have a bowel movement, you will feel piercing pain, dry stool, difficult to pass, and even dare not to defecate. This leads to a vicious cycle. Many patients will also find many small growths in the anus. Tumor, every time I defecate, it is not clean and very painful.

    So, what caused the above situation? I want to remind everyone, don't think it is "hemorrhoids", in fact, it is very likely that "anal fissure" is at work.

    What is "anal fissure"?

    As the name suggests, an anal fissure is a crack in the anal canal. Medically, the full-thickness of the skin of the anal canal splits longitudinally and forms an infectious ulcer, which is called anal fissure. "Anal fissure" has been recorded in our ancient Chinese medicine classics for a long time, and it is called "hook intestinal hemorrhoids" and "split hemorrhoids" in Chinese medicine. In Qing Qi Kun's "Surgery Dacheng", it was recorded that "Hooked intestinal hemorrhoids, hemorrhoids inside and outside the anus, broken creases, stools like sheep feces, bleeding behind the feces, foul smelly and painful people...". Qing·Wu Qianzhi’s "Golden Mirror of Medicine: Essentials of Surgical Heart Techniques" has a record of "the anus is broken around the folds, and those with bowel knots will cause dryness".

    There are three obvious clinical manifestations of anal fissure: periodic anal pain, bleeding and constipation.

    Anal pain is the main manifestation of anal fissure. The cause is mostly constipation. Forced defecation leads to rupture of the anal canal. The pain is knife-like pain or burning. The pain reduces or disappears within a few minutes to ten minutes after defecation, which is called the pain intermittent period. The pain reappears about half an hour after defecation. This pain is sometimes more severe than the pain during defecation, and often lasts for several hours before gradually alleviating. This form of pain is medically called periodic pain of anal fissure.

    The blood in the stool of anal fissure is mostly blood on toilet paper after defecation. Sometimes, blood dripping during defecation can also be seen. The color is mostly bright red, and it is mostly attached to the surface of the stool. Blood in the stool will increase accordingly when constipation is severe.

    Constipation and anal fissure are mutually cause and effect, and the two influence each other. Most patients with anal fissure have constipation. Dry and hard bowel movements can tear the skin of the anal canal and cause anal fissure. Severe anal pain will cause many patients to feel fear of defecation, unwilling to defecate, and then accumulate stool. When the stool stays in the anus for a long time, the stool will dry up due to excessive water absorption, and the pain caused by defecation will be more severe. Further aggravate anal fissure, which leads to a vicious circle.

    What are the causes of anal fissure?

    Western medicine believes that long-term constipation and mechanical damage are the main factors for the formation of anal fissures. Local injury is the direct cause of the formation of anal fissure. Dry stools, foreign bodies, childbirth, excessive force during defecation, etc. can cause skin damage to the anal canal, and secondary infections become anal fissures. High pressure on the posterior wall of the anal canal and poor blood supply to the superficial sphincter of the anal canal are anatomical factors for the formation of anal fissures. Congenital deformities, trauma or surgery can cause anal canal stenosis. Dry and hard stools can easily cause skin tears in the anal canal. Bacteria invade the infection to form ulcers and cause anal fissures. Patients with anal fissure have excessive internal sphincter contraction and enhancement activities. Reflex internal sphincter contraction is the main factor in the formation of anal fissure pain cycle and one of the main reasons why anal fissures are not easy to heal.

    Traditional Chinese medicine believes that this disease is mostly caused by improper diet, excessive drinking, and overeating spicy foods, resulting in internal constriction of dryness and heat, depletion of body fluid, moisturizing the large intestine, or body blood deficiency, deficiency of blood and body fluid, dryness, intestinal tract Loss of moisturizing, resulting in blood heat, intestinal dryness or yin deficiency and lack of body fluid, constipation, forced defecation, causing anal skin lacerations, dampness toxins, etc., enter the skin and collaterals by virtue of deficiency, local qi and blood stagnation, poor operation, and ulceration There is a lack of qi and blood nutrition, and anal fissure is formed after a long time.

    Who are prone to anal fissure?

    Generally speaking, the susceptible population of anal fissure is mainly patients with long-term constipation. Patients with anal fissure are mostly young and middle-aged. The age group of 20-40 years old is the high incidence of this disease. The ratio of male to female is about 1:2.5, and the incidence of women is relatively high. Excessive drinking, eating spicy food, sitting for a long time, drinking too little water, poor defecation habits, etc., causing stools to stay in the intestines for too long, difficult to discharge, or even a few days to discharge, each time due to forced defecation, anal fissure occurs .

    There are also anal fissures in some special populations. For example, patients with tuberculosis and Crohn’s disease often form anal fissures in the anal area. Some STDs, hematological diseases, and colorectal anal canal tumors also form anal fissures in the anal area, but these special types The anal fissure is very different from the general anal fissure in the location and the shape of the anal fissure.

    How to judge whether I have anal fissure?

    What are the treatment measures for anal fissure?

    The treatment of anal fissure should first soften the stool, change the bad bowel habits, and keep the stool smooth. You must drink more water and eat more fiber-rich foods to avoid excessive force during defecation. If necessary, you can use drugs to defecate. The electrolytes of western medicines are scattered and dissipated. Sailu, the traditional Chinese medicine Maren pill, Runchang oral liquid, etc., promote the smooth discharge of stool. In some early anal fissure patients, the anal fissure can heal by itself on the basis of softening the stool, keeping the stool smooth, and improving the bowel habits.

    Fumigation and washing method: commonly used Wubeizi Decoction, Kushen Decoction, etc., which have the effects of promoting blood circulation and relieving pain, astringent and reducing swelling, etc., or use medicinal liquid as hot and wet compress, or use 1:5000 potassium permanganate solution to sit in the bath after defecation every day . Sit bath before toilet can relax the anal sphincter to reduce the irritation of feces to crack sore; after sitting bath, it can wash the feces and keep the local clean, avoid foreign body irritation to the ulcer wound, improve local blood circulation, and reduce the spasm of anal sphincter. Relieve pain and promote ulcer healing.

    Medication or Suppository Method: Put various suppositories and ointments that have the functions of protecting mucous membranes, lubricating intestines, relieving pain and stopping bleeding into the anus or smearing them on the affected area, melting under the action of body temperature and directly acting on the affected area, eliminating and improving symptoms , Such as various hemorrhoid suppositories and hemorrhoid ointment on the market, have very good effects on improving the symptoms of anal fissure and promoting wound healing.

    Surgical treatment: non-surgical treatment is ineffective, and recurrent symptoms gradually aggravate, surgical treatment is required. The purpose of the operation is to relieve anal stenosis and sphincter spasm, promote the healing of the crack, and remove the tissue that has been pathologically changed. There are different surgical methods depending on the condition of the anal fissure.

    Prevention of anal fissure:

    1. Develop good bowel habits and treat constipation in time.

    2. The diet should contain more fruits and vegetables to prevent dry stools and avoid scratches on the anus with rough stools.

    3. Pay attention to anal cleansing to avoid infection, and treat as soon as possible after anal fissure to prevent secondary anal diseases.

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