[Overview] Hemorrhoids are soft venous clusters formed by the expansion and varicose of the rectal venous plexus under the mucosa of the rectum and under the skin of the anal canal. Men, women and children can get the disease, with adults over 20 years old accounting for the majority. According to the different parts of the disease, there are three types: internal hemorrhoids, external hemorrhoids and mixed hemorrhoids.
1. What is internal hemorrhoids? What are the characteristics?
Answer: It occurs above the tooth line of the anal canal, and the soft venous mass formed by the expansion of varicose and congestion of the hemorrhoidal venous plexus under the mucous membrane of the rectum is called internal hemorrhoids, which usually occurs at 3, 7, and 11 points of the lithotomy site. Its clinical features are blood in the stool, prolapse of hemorrhoids, and anal discomfort.
2. What is the cause of internal hemorrhoids?
Answer: The occurrence of internal hemorrhoids is related to wind, dampness, blood stasis and qi deficiency. In addition, the visceral organs are weak, wind-dryness and damp heat are forced, blood stasis obstructs Pomen, blood stasis and turbid qi stagnation, and tendons and veins are disintegrated, leading to visceral dysfunction. Into hemorrhoids.
3. What are the manifestations of internal hemorrhoids? What will the clinical examination find?
Answer: Internal hemorrhoids mostly occur in adults, but rare in infants and young children. The manifestations are as follows: ① Blood in the stool is the most common symptom of the disease. Most of the toilet tissues are stained with blood during defecation, and even spotting or jet bleeding may occur. Stools are not mixed, bright red in color, mostly painless, with intermittent attacks. Symptoms are often aggravated by drinking, fatigue, constipation, and diarrhea. ②Prolapse With the prolonged course of the disease, the hemorrhoids will gradually increase, and they may protrude outside the anus during defecation. The color of the prolapses is bright red or gray. If they are not brought back in time, local swelling may increase. ③Perianal dampness and itching Hemorrhoids prolapse repeatedly, anal sphincter muscles are loose, and secretions are often overflowing outside the anus, so they feel that the anus is damp; secretions stimulate the perianal skin for a long time, which can easily cause perianal eczema, itching and discomfort. ④Pain The prolapsed internal hemorrhoids are incarcerated, causing edema, thrombosis, erosion and necrosis, and severe pain. ⑤Constipation is often due to fear of bleeding, artificial control of bowel movements, changes in bowel habits, or habitual constipation; long-term constipation or dry stools can easily scratch the surface of hemorrhoids and cause internal hemorrhoids bleeding. The two are mutually cause and effect, leading to aggravation of the disease. .
Digital rectal examination can palpate mucosal nodules with soft, smooth surface and no tenderness. Anoscopy or endoscopy can show dark red nodules on the dentition.
4. How to stage internal hemorrhoids?
Answer: The stages of internal hemorrhoids are as follows:
Stage I: The hemorrhoids are small and do not prolapse, so that the blood is the mainstay; Stage II: The hemorrhoids are large, prolapse outside the anus during defecation, and can be absorbed by themselves after defecation, with more or less stools; Stage III: Hemorrhoids are larger, and when defecate Hemorrhoids prolapse outside the anus and cannot be absorbed by themselves. Generally, they do not bleed. Once bleeding occurs, they will be spray-like. If the hemorrhoids are not repaid as soon as possible after the hemorrhoids prolapse, they will be easily incarcerated, strangulated, swollen, eroded and necrotic.
5. What are the treatment methods for internal hemorrhoids?
Answer: There are three methods of treatment for internal hemorrhoids: internal medicine, local external treatment and surgical treatment. Generally speaking, internal treatment and external treatment are conservative treatment methods, mainly to control and eliminate clinical symptoms; for severe internal hemorrhoids, surgical treatment can be used, but the indications should be strictly controlled and the appropriate surgical method should be selected.
Internal treatment: It is mostly suitable for hemorrhoids in stage I and II; or internal hemorrhoids incarcerated with secondary infection; or old and weak; or internal hemorrhoids with other serious chronic diseases that are not suitable for surgical treatment.
Wind-injured intestinal collateral syndrome: stool with blood, dripping or jet-like bleeding, red blood, or anal itching, red tongue, thin white or thin yellow coating, floating pulse; treatment is to expel wind and moisturize dryness, clear heat and cool blood Mainly, the prescriptions are Liangxue Dihuang Decoction, Sophora japonicus powder plus and minus: Angelica, Shengdi, Chuanxiong, Red Peony, Scutellaria, Poria, Tangerine Peel, Safflower, Licorice, Ginger, Wulingzhi, Stir-fried Sophora japonicus, Platycladus orientalis, Vitex Mustard ear, citrus aurantium, etc.
Damp-heat betting syndrome: the stool is bloody, the volume is large, the tumor in the anus comes out, it can retract on its own, the anus is burning, the tongue is red, the coating is thin and yellow, and the pulse is slippery; the treatment is mainly to clear heat and remove dampness to stop bleeding. Use the addition and subtraction of Zanglian pills: Coptis, boar large intestine, Diyu charcoal, agrimony, etc.
Qi stagnation and blood stasis syndrome: prolapse of mass in the anus, or even incarceration, anal canal contraction, painful swelling, and even thrombosis at the anal margin, edema, obvious tenderness, dark red tongue, white or yellow coating, thin pulse string Astringent; the main treatment is to promote blood circulation to remove blood stasis, regulate qi to relieve pain, and use the decoction for promoting blood circulation and dissipating blood stasis: angelica, red peony root, peach kernel, rhubarb, chuanxiong, hematoxylin, Danpi, Citrus aurantium, melon, betel nut, etc.; or pain relief Rushen decoction: Gentiana, peach kernels, saponins, atractylodes, parsnip, cork, angelica, Alisma, betel nut, ripe rhubarb, etc.
Syndrome of spleen-deficiency and qi depression: anal swelling, swelling in the anus, need for manual reduction, fresh or pale stools, pale complexion, dizziness, fatigue, lack of qi, lazy appetite, loose stools, pale tongue, There are tooth marks on the sides, thin white fur, and weak pulse. The treatment is mainly to invigorate the spleen and nourish the qi, nourish the blood and invigorate the blood. The prescriptions include the addition and subtraction of Buzhong Yiqi Decoction: astragalus, ginseng, licorice, angelica, orange peel, cohosh, Bupleurum, Atractylodes, Habitat, Red Peony Root, Chuanxiong, etc.
External treatment method: Suitable for hemorrhoids and internal hemorrhoids incarcerated swelling, pain, bleeding, etc., common methods are:
Fumigation and washing method: mainly to invigorate blood and relieve pain, converge and reduce swelling. The prescription is to add and subtract gallnut decoction: gallnut, puxiao, mulberry, lotus, nepeta, etc.; or sophora decoction: 60 grams of Sophora flavescens, 30 grams of Cnidium, 15 grams of Angelica dahurica, 30 grams of honeysuckle, 60 grams of chrysanthemum, 15 grams of cork, 15 grams of Kochia scoparia, 9 grams of calamus, etc.
External application: suitable for hemorrhoids in various periods and dressing changes after surgery, mainly for reducing swelling and pain, astringent, stopping bleeding, transforming decay and promoting muscle growth. Commonly used are Wubeizi powder and Xiaozhi ointment.
Suppository method: applicable to hemorrhoids in various periods. It has the functions of clearing away heat and swelling, relieving pain and bleeding, such as hemorrhoid suppository.
There are also injection therapy, drug insertion therapy (dry hemorrhoid nail therapy), ligation therapy, injection plus ligation therapy, anal expansion therapy, cooling therapy, cryotherapy, infrared coagulation therapy, laser therapy, and hemorrhoid stapler circumcision. Treatment of internal hemorrhoids.
6. What are the prevention methods for internal hemorrhoids?
Answer: The prevention methods of internal hemorrhoids include: keep the stool unobstructed, develop the habit of defecation every day, control the time of each defecation; pay attention to the combination of work and rest, wash the anus every day, keep the area around the anus clean and dry; pay attention to diet and drink more Boiling water, eat more fruits and vegetables, and eat less spicy food; avoid sitting for long periods of time, do regular levator ani exercises, and choose appropriate exercises; once diagnosed with internal hemorrhoids, timely and effective diagnosis and treatment should be performed to prevent the development of the disease.