Outpatient TCM anorectal clinic visit guide
(1) Internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids: According to epidemiological statistics, the incidence rate is the first among anorectal diseases, accounting for more than 80% of the patients. The main clinical manifestations are prolapse of anal mass during defecation, blood in the stool, swelling and pain, and dampness around the anus accompanied by mucus.
(2) Anal fissure: The incidence is second only to hemorrhoids. The main clinical manifestations are obvious pain during defecation, pain can be aggravated after defecation, periodic pain in the anus, constipation and a small amount of blood in the stool. It usually occurs in the middle of the anus.
(3) Perianal abscess and anal fistula: Perianal abscess is a purulent lesion formed by acute infection of the soft tissue space around the anal canal and rectum, also known as peri-anorectal abscess. The main symptoms are swelling and pain around the anal canal and in the rectum. Perianal abscess is called anal fistula due to pus formation and self-ulceration or the cavity left after incision is called anal fistula. The main symptom is repeated perianal discharge of pus. Very few have the possibility of cancer.
4. Constipation: Constipation can be divided into outlet obstructive constipation and colonic slow transit constipation according to anatomical morphology and physiopathology. Our department mainly diagnoses and treats patients with outlet obstructive constipation. It is more common in women and elderly patients. It is difficult to pass stool and discharge. Prolonged time, the first part of the stool is hard, the latter part is soft or thin, and the number of stools is less than 2 times a week. Patients with this type of constipation can occur from rectal protrusion, pelvic achalasia syndrome, and rectal prolapse.
5. Colorectitis and anal sinusitis: Chronic enteritis and anal sinusitis can be caused by long-term diarrhea, constipation, and spicy diet to stimulate tobacco and alcohol. The main symptoms are long-term changes in stool characteristics, mucus jelly-like stools, with or without Pus, swelling of the anus, burning, moisture around the anus, and pain in the left lower abdomen and around the umbilical cord.
6. Rectal prolapse: The anorectal mucosa or full-thickness of the rectum, or even partial prolapse of the sigmoid colon during defecation or daily life, mainly seen in the elderly and children. The main symptoms are blood in the stool, prolapse of anal mass, accompanied by obvious damp mucus and occasional diarrhea.
7. Colorectal cancer: Colorectal cancer is one of the most common malignant tumors. Relevant data show that the incidence of colorectal cancer accounts for the fourth place among all malignant tumors. The main symptoms are blood in the stool, abdominal pain, changes in stool characteristics and abdominal masses, fatigue and weight loss, anemia, etc. Early preventive diagnosis is very important, and it is recommended to be over 50 years old As far as possible, perform a digital anal examination and colonoscopy once a year.
8. Colorectal polyps: Mainly divided into multiple colorectal polyps and single colorectal polyps. The former usually have family history and high cancer rate. The main symptoms may be abdominal pain and diarrhea, with or without bloody stools, and ulcerative colon. Multiple inflammatory polyps can also be seen during the outbreak of inflammation. The latter may have no symptoms, with or without abdominal pain, diarrhea, blood in the stool and other symptoms, and the prognosis is good.
9. Perianal skin diseases: Perianal eczema and perianal condyloma are the most common perianal skin diseases. Perianal eczema is mainly manifested as pleomorphic skin lesions of the perianal skin, with papules, blisters, and lichen planus. The symptoms are mainly perianal itching and burning, and perianal skin running water, etc.; condyloma acuminatum can be diagnosed by acetic acid white test and the scope of the lesion After surgery, the main manifestations may include perianal itching and running water.
To sum up, the above various diseases are nothing more than symptoms such as blood in the stool, swelling and pain, prolapse, pus, constipation, and secretions, which can be briefly summarized as:
1. Blood in the stool:
Internal hemorrhoids: blood does not mix with stool, it is attached to the surface of stool, or drips during stool, or a thread is like an arrow, blood is too much without pain.
Anal fissure: Less blood in the stool and pain in the anus.
Rectal polyps: Children have blood in the stool, and the frequency and nature of stools have not changed significantly.
Rectal cancer: mixed blood and mucus, its color is dull, and the anus feels heavy.
2. Swelling and pain:
It is more common in paraanal abscess, internal hemorrhoid incarceration, external hemorrhoid edema, and thrombotic external hemorrhoid.
Stage II and III hemorrhoids, rectal polyps, anal papilloma, and rectal prolapse.
4. Pus: paraanal abscess, anal fistula.
Hemorrhoids, anal fissure, paraanal abscess, anorectal cancer.
6. Secretions: Prolapse of internal hemorrhoids, rectal prolapse, anal fistula.