2020年10月13日星期二

what does a hemorrhoids look like,Questions and answers in the QQ group by Zheng Lihua, director of the Anorectal Department of China-Japan Friendship Hospital

    The text version is in the form of one question and one answer, all based on Director Zheng’s oral records. It is the authoritative answer to the anorectal knowledge. Please study carefully. These questions are also the most frequently asked by administrators every day, so you will benefit a lot after reading them carefully.

    In the future, the group will regularly invite Director Zheng to answer questions for everyone, and the time will be notified in advance in the group announcement. Because Director Zheng is very busy at work, please don't disturb Director Zheng at ordinary times, and talk freely when you answer questions. Thank you for your participation and cooperation.

    The following questions and answers are highlights of this Q&A.

    Note: Q is the question, A is the answer. The content in brackets is the group leader's comment.

    Q1: What about scar infection after anal fistula surgery?

    A: There is no problem of scar infection after anal fistula. If there is secretion on the scar, it may be uncomfortable. Because the scar has poor elasticity and does not heal well, some intestinal juice will flow out. As the scar gradually softens, There is no problem, it usually takes about three months to half a year, no need to deal with.

    Q2: 45 days after anal fistula, there is a small hole in the wound on the picture

    A: It is recommended to observe and observe again. You can take a cotton swab and apply it with Jingwanhong ointment for a period of time. It must be applied to the wound. It can grow slowly without worry.

    Q3: What should I do if the stool is too thin after hemorrhoids surgery?

    A: The stool is thin because of the poor elasticity of the scar. After the scar gradually softens, the stool will return to its normal thickness. Don't worry, if it takes a long time, it is still in this state. You can do a small treatment of expanding the anus. (It is recommended to find a professional doctor to operate the anus enlargement, not by yourself)

    Q4: Why is the wound whitish after the operation?

    A: It is a good thing for the wound to become whitish after the operation. The whitishness means that the wound is crawling. It is the last stage of the wound recovery. Don't worry. Finally, the wound will turn into a white scar, and then slowly recover into the skin. colour.

    Q5: Why is there a small fleshy ball in the wound ten days after mixed hemorrhoids operation?

    A: Normal wounds are open-ended, and the margins of the wounds are a bit eversion. This is okay. When the wounds grow well, these fleshy balls will disappear and are absorbed. Don't worry. (Some skin bridges are specially reserved by the doctor to prevent postoperative anal stenosis. Don't worry about it)

    Q6: Why is anal sinusitis not cured for a long time?

    A: Anal sinusitis is indeed a more difficult disease to treat. This disease is chronic inflammation and is mainly related to resistance. Therefore, if you want to prevent and treat anal sinusitis, you must enhance your resistance, most importantly sleep . Adjust your sleep well and your resistance is sufficient. At this time, anal sinusitis can be cured relatively easily. Generally, some anti-inflammatory suppositories can be used: Kangtai suppository, Huazhi suppository, Hemorrhoid Ning suppository, and Mecindole same suppository. Eat less irritating food and don't squat for a long time.

    Q7: 44 days after the operation, what should I do if the wound has not grown?

    A: This is also normal, because the wound on the outside grows faster, the wound on the inside grows slowly, and the drainage is poor. It is not enough to use a plug, because the plug is mainly inserted into the anus for protection For the role of mucous membranes, some ointments should be used, including Jingwanhong ointment, Dragon Ball ointment, and Chuangyuning. They must be applied to the wounds that have not grown. It is useless to apply on the outside. You must use cotton swabs to apply this To apply the ointment, you can add a little Chinese medicine to the sitz bath before applying the ointment, because during the sitz bath, the anal canal is moved down, the wound can be soaked in the Chinese medicine, and then a little more ointment is applied. If you grow up, you should also be careful not to dry your stool.

    Q8: Eight months after the anal fistula is hooked up, why does the anus sometimes itch?

    A: Because it is a high anal fistula, especially after the thread is hooked up, the scar is relatively large. At this time, the anus is closed badly. Sometimes some intestinal fluid will flow out, irritating the perianal skin, and it will cause itching and dampness. Normally, you can use some light salt water to take a bath, and usually pay attention to keeping the part dry. (It is recommended that you do not wear tight underwear and outer pants, and keep your anus dry and ventilated)

    Q9: Can patients with anal fistulas, abscesses, hemorrhoids and other anorectal diseases eat spicy food and drink alcohol?

    A: After recovery, you can eat it in moderation, not a large amount of continuous consumption. (These can be used in moderation after a complete recovery)

    Q10: After anal fistula operation, there is a hard bag 2 cm away from the wound and then it is absorbed.

    A: Because anal fistula is sometimes infected, it will stimulate the tissues around the anus, and it will become inflamed and hard. After the anal fistula is healed, these inflammatory tissues will become soft after they are slowly absorbed. It should not be another An infection foci, the problem is not big, then observe and observe.

    Q11: What should I do if granulation appears 18 days after hemorrhoid surgery? What to do with bowel movements three times a day?

    A: If the granulation can be absorbed by the peanuts, no special repair is needed. There are a lot of stools three times a day. Generally, two times are not a big problem. As long as it is formed, it is not a big problem. If it is thin or has diarrhea, you need to eat it. Some flora adjustment medicine. (If granulation occurs, it is recommended to review, and the doctor will deal with the situation of granulation)

    Q12: Does pulling the thread after high anal fistula have any effect on recovery? When can I get pregnant?

    A: It’s okay to pull the line over, it’s okay to pull it off slowly, and there will be no adverse effects. The medicines used in our anorectal surgery are very safe. To be conservative, there is no problem with three months of pregnancy.

    Q13: How to treat puborectum and spasm?

    A: This disease is mainly treated by symptoms. Treat it if you have symptoms, and leave it alone if you have no symptoms. If you have outlet obstructive constipation, you can consider hanging the line for treatment. If there are no symptoms, you can sit in warm water for five minutes before bowel movements every day.

    Q14: Can it work normally 45 days after mixed hemorrhoid surgery?

    A: No problem, you can work normally, that is, don't sit for a long time, get up and move around in the middle, you can try jogging these sports, and do what you can.

    Q15: Is there still a radical operation for anal fistula after drainage of perianal abscess?

    A: This must be done. You can do a B-ultrasound first to perform the anal fistula operation. If you don't do it, you will get swollen and infected again, and the treatment will be more troublesome.

    Q16: I want conservative treatment for mixed hemorrhoids one and a half years postpartum

    A: The most important thing is to keep the stool smooth, not dry, shorten the defecation time as much as possible, don't be too tired, don't squat for a long time, eat less irritating food, if you feel unwell, you can use some suppositories and ointments.

    Q17: Mixed hemorrhoids, anal fissures, and anal nipple hypertrophy are all. Do I need surgery?

    A: After seeing your pictures, I suggest you hurry up, especially if you have symptoms of prolapse, there is no need to bear it anymore. You can take some Chinese medicine to adjust constipation. If you have black stool, it has little to do with the disease in the anus. See if it has anything to do with your diet. If you have black stools for about half a month, it is recommended to have a colonoscopy. (If you have black stool, it is not a dietary problem, such as eating pig liver, spinach, etc. the previous night, then it is recommended to have a colonoscopy, and a gastroscope is also recommended)

    Q18: How to adjust the soft stool?

    A: You can take some medicines that adjust the flora, such as Pefeikang, Zhengchangsheng, and Meichangan. They are all two-way adjustments, which can make your stool more shape. The mixed hemorrhoid surgery performed at the China-Japan Hospital generally does not require expansion of the anus, because during the operation, we will carefully check the tightness of the anus. Generally, under anesthesia, like my fingers are thinner, three fingers can be inserted. , You can enter the middle finger under non-anaesthetic state, the tightness is just right, there is no need to expand the anus.

    Q19: What should I do if there are three small meat balls outside the anus after mixed hemorrhoids?

    A: You don't need any medicine. You can run or exercise. It's a normal person. It can be absorbed slowly. Just be careful not to dry the stool, don't constipate, and don't try to remove the crossbow. (Skin bridge, to prevent anal stenosis, don’t care, it will disappear slowly)

    Q20: Two and a half months after hemorrhoids and papilloma, what's the matter with occasional pain and itching? Can lamb and seafood be eaten?

    A: Taining suppository can be used for a few days. This is normal. The scar of the wound has not been completely softened. You can wash it with light salt water. Lamb and seafood can be eaten, the spicy ones can be eaten less. (It is recommended to stop eating for a while, the days to eat good things will be long)

    Q21: What should I do with dry stool and bleeding three months after mixed hemorrhoids?

    A: No problem. You can use Taining Suppository for a few days. The mucous membrane may be punctured by the hard stool. This is normal, and it doesn't matter.

    Q22: Why is there no bleeding in stool for eight days after the operation of hemorrhoids?

    A: Eight days after the operation, these conditions are normal. At least it will take more than 20 days. Don't worry, you will recover slowly.

    Q23: Does mixed hemorrhoid surgery affect the anal sphincter?

    A: This is a relatively common problem. Many patients will be troubled and worried before surgery. I can tell you this. The mixed hemorrhoid surgery performed in China and Japan basically does not involve the sphincter, which means that there is nothing to the sphincter. Damage, so it will not cause any incontinence of the sphincter, so don’t worry.

    Q24: Five months after anal fistula surgery, what is going on with the pain in the incision after sitting or drinking for a long time?

    A: Try to avoid sitting for a long time. If you are driving a long distance, it is recommended to take a rest for about an hour. Drink less liquor and drink in moderation.

    Q25: What happened to the perianal fever 46 days after abscess drainage? Is it related to anemia?

    A: If there is no fever in the body temperature or the perianal swelling does not occur again, it can be maintained for a period of time, but after the drainage, it is still necessary to have another radical anal fistula operation. This phenomenon has nothing to do with anemia. You can continue to take iron supplements. Be careful not to have dry stools. Go to the hospital to check if you have time. If a fistula develops, perform an operation as soon as possible.

    Q26: Internal hemorrhoids are minimally invasive, and external hemorrhoids are traditional. What should I do if I have edema?

    A: As long as the edema does not exceed the size of peanuts, it is not a big problem and can be absorbed. It can be observed and observed. It is normal for a little blood in the anus. It will take at least ten days to heal.

    Q27: Why is there almost no wound in 38 days after anal fistula surgery?

    A: Ordinarily it’s impossible. If it’s really not as long as you said, you still need a doctor to check to see if there are any other problems, if there are other lesions, and if there are any ligated thread ends. . It should grow for sure, maybe it grows slowly inside, or you can apply Jingwanhong ointment to the wound first, or take Taining suppository for a few days and observe, but 38 days is true for a status anal fistula Slightly longer, the wound of status anal fistula is generally not too big.

    Q28: How can I judge whether I have false healing?

    A: This problem is also a problem that our patients are particularly concerned about. We are very worried about whether there is false healing. In fact, the probability of false healing is very low. Generally, patients cannot judge by themselves, only the deeper ones and the higher ones. Anal fistulas and abscesses may have false healing. For hemorrhoids, anal fissures, and anal papillomas, there is no false healing. Don’t worry about this. If you go to the hospital for high-level anal fistulas and abscesses for regular dressing and examination, this The problem is completely avoidable, so don't worry too much about it.

    Q29: If something comes out from the anus, do I need surgery to repay it?

    A: This symptom is already in the third stage of hemorrhoids, and it should be treated. If you get more and more hemorrhoids in the future, the pain will be greater during the operation and there will be more wounds. Therefore, once the prolapse, we recommend surgery as soon as possible.

    Q30: What should I do if there is a small wound that did not grow well during the operation on May 20? Can colonoscopy be done?

    A: If it is in the anus, it is possible, because the recovery in the anus is relatively slow. It may reach two months and it has not fully recovered. You can apply some Jingwanhong ointment, which should grow on the intestine. In the case of endoscopy, it is recommended to do it after the wound has healed, because if there is a wound, it is still more painful to do colonoscopy.

    Q31: The wound has not grown well after anal fissure, what should I do if the doctor says that the anus is narrow?

    A: If the doctor says that your anus is a bit narrow, it is recommended to expand the anus. After 34 days after the expansion, the anus is indeed a little longer. I don't know how you expanded it. Is it conservative? If the anus is narrow, the wound is really not long, and it should grow well soon after expanding the anus, and it will not cause symptoms such as abscess or anal fistula. Don't worry about this.

    Q32: Is it normal that mixed hemorrhoids have not grown well after 28 days?

    A: This is normal, and some secretions are also normal. Everyone’s physique is different. Some people can grow well in more than ten days. Some people may grow up to about a month or even longer. This is based on each person. The surgical condition, wound size and physical condition of the patient are treated separately, so don’t worry.

    Q33: Is surgery necessary for the initial diagnosis of anal fistula?

    A: Since it has been diagnosed as an anal fistula, I should pay close attention to the surgical treatment, because it will only get more and more serious. It is impossible to heal itself. It is meaningless to pay attention to anal hygiene.

    Q34: I have hemorrhoids and blood stains when my fingers enter the anus. Do I need surgery?

    A: If there is blood stains in the fingers but not prolapsed, the operation can be postponed. Of course, if the bleeding is caused by anal fissure, it is recommended to treat it before going abroad. If it is only an internal hemorrhoid, you can put Taining Suppository for a few days first. It is best to do an anoscopy.

    Q35: Do I need to change the dressing every day 5 days after the incision of the low anal fistula?

    A: The incision of the status anal fistula is very clear, and the effect is very good. I think it doesn't matter if the status anal fistula is changed or not. I have many patients who recover very well without changing the dressing, so don't worry.

    Q36: Is the perianal abscess a physical problem? Will you get it once and then you will get it often?

    A: Perianal abscess is indeed a physical problem, but generally it will not be committed again after one time. Very few people may still commit it. Your wound is growing well, it is indeed a bit slow. You can put on some ointment to see if it is not a big problem.

    Q37: I still have edema after mixed hemorrhoids. Do I need to continue bathing?

    A: Looking at the picture, the wound has healed. You can stop the sitz bath, because prolonged sitz bathing is not good for edema and may aggravate edema.

    Q38: In what season can anorectal diseases recover faster with surgery?

    A: As far as our current surgical technology and environment are concerned, there is no problem at any time, including this hot summer day. (When you get sick, surgery is of course the same. This is not the best way to get sick, the most important thing is to treat the disease early)

    Q39: Why is there a foreign body sensation in the anus after anal papilloma?

    A: Since there is no problem with the anoscope, it is the stimulation of the scar. It does not matter. When the scar gradually softens, the foreign body sensation will disappear. Don't worry, slowly recover.

    Q40: After the perianal abscess surgery, the wound is itchy, what's the matter with the scar on the hard bench?

    A: Look at your picture, the wound has grown, and itchy wounds can be washed with light salt water. It is normal to feel the same with scars on a hard bench. After half a year, these conditions will disappear naturally after the scars have softened.

    Q41: What should I do if the scar is too large and the bowel control is poor?

    A: Looking at the picture, the scar is indeed larger, and the stool control will be poor. However, as the wound grows and the scar gradually softens, it will gradually get better. Be sure to make the stool shape.

    Q42: 12 days after PPH, what should I do if my stool is very painful?

    A: I don't know if you have also removed external hemorrhoids, or whether the wounds of external hemorrhoids caused stool pain. Make sure that the stool is not dry. You can take a bath with warm salt water. (Is the position of the stapler too high, it is recommended to check again)

    Q43: I have anal fissure, and the pain is not very strong when I defecate. Do I need surgery?

    A: Generally, if an anal fissure causes sphincter spasm and anal stenosis, we recommend surgery as soon as possible. If you have a good bowel movement, then maintain it first. If the skin tag does not hurt, just ignore it. You can be conservative.

    Q44: Is it normal that there is still pain for 40 days after the operation of circular mixed hemorrhoids?

    A: It is normal for ring-shaped hemorrhoids to feel pain for 40 days. After all, the wound is relatively large. Whether it is narrow depends on the condition of your stool. Whether the stool is hard or not, do not use your fingers directly. Our doctors also use it when doing digital examinations. Paraffin oil, if you don’t have lubricating oil, it will definitely be more difficult to get in and out of the anus. If the stool shape can be shaped and effortlessly, there will be no narrowing problem.

    Q45: I have anal fistula and hemorrhoids, should I have surgery before pregnancy?

    A: Looking at your picture, the hemorrhoids are not small. You must have surgery before getting pregnant, otherwise the pregnancy will be very painful and you can't use medicine. (Anal fistula must be operated before pregnancy, otherwise there will be a risk of miscarriage)

    Q46: What should I do if the stool is always finer after mixed hemorrhoids?

    A: The scar will be harder in the short term after the operation, so the stool will be thinner. After a long time, the scar will gradually soften, and the stool will naturally be normal. If it is still thin after half a year, you can come to review and simply treat it for you.

    A letter from Director Zheng to the national patient group and China-Japan patient group:

    I would like to thank the group owners and administrators of our two groups-these very enthusiastic friends, who worked so hard and persisted for such a long time, to answer questions for our patient friends. They are all very Experienced, but also very professional, can answer the questions of our new patients. They are able to do this charity thing with such perseverance, I think it is very touching to us, and it is a positive energy that is very worthy of our promotion. I think those who have received their help must be grateful. We can continue to help other new patients in the future and continue to carry forward this good tradition. This is also our wish to be doctors. Due to our lack of energy and time, our two groups have shared a lot of pre-operative and post-operative consultation and psychological counseling for us. I am very grateful in my heart. Thank you for your hard work! Here, I solemnly say to you: Thanks!

    July 30, 2016

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