2020年12月31日星期四

hemorrhoids or anal cancer,Hematochezia and rectal cancer --- Speaking of the death of Zhuang Zedong

    On February 10, 2013, at the time of the traditional Chinese New Year, Zhuang Zedong, a Chinese and American ping-pong diplomat and veteran of the table tennis world, unfortunately passed away in Beijing, ending his legendary life, shocking and regretting the world. According to industry insiders: Zhuang Lao was misdiagnosed for two years, rectal cancer has been treated as hemorrhoids.

    The incident started in 2006. Mr. Zhuang once had blood in the stool. I didn't care about it. He thought it was bleeding from hemorrhoids. After that, he went to a hospital and was also rashly diagnosed as hemorrhoids. Later, he went to two hospitals in Beijing for examinations, and both upheld the "original verdict." Because Lao Zhuang was busy giving lectures to various places before the Beijing Olympics, he didn't check it carefully. Until July 29, 2008, Mr. Zhuang came to another hospital in Beijing for an examination. After a simple digital rectal examination, he was diagnosed with rectal cancer and had metastases in the liver and lungs. Experts said that radical treatment was impossible. surgery. The next day, Mr. Zhuang rushed to a major hospital in Beijing. After some examination, he found that the rectum 7cm from the anus had been blocked by a tumor 4/5. The doctor informed him that he had been delayed for more than two years. Lao Zhuang immediately underwent surgery on August 7. However, due to the advanced stage of the tumor, palliative surgery can only be performed, and the effect is necessarily not ideal.

    This lesson is profound and painful. Therefore, we must pay attention to treating blood in the stool. Since blood in the stool is the most common early symptom of internal hemorrhoids, most people always regard blood in the stool as a hemorrhoid attack. Because of this misunderstanding, many people often use some suppositories to treat hemorrhoids when they have blood in the stool, and the symptoms will probably get better. However, for middle-aged and elderly people, blood in the stool may be a danger signal of rectal cancer, and sufficient vigilance must be aroused. In recent years, the incidence of rectal cancer has increased year by year, but the early symptoms of rectal cancer are not obvious, and it is most likely to be ignored by patients and even misdiagnosed by doctors.

    So, what is the difference between hemorrhoid blood in the stool and rectal cancer? How should we distinguish it in our daily lives? Hemorrhoids manifest as bleeding in the anus after defecation, the blood is bright red, does not mix with the stool or the stool is bloody, and then drips blood, or even spray-like bleeding, and the bleeding stops after the stool. Internal hemorrhoid bleeding is generally intermittent. Dry stools, fatigue, drinking, and overeating irritating food are often triggers for bleeding. A small number of patients can develop severe anemia due to long-term repeated hemorrhoid bleeding.

    But the blood in the stool of rectal cancer is dark red, usually mixed in the stool, with blood and mucus in the stool. Of course, it is best to go to the hospital for an examination immediately when there is blood in the stool. The doctor only needs to perform a simple digital rectal examination to make a preliminary judgment. The digital rectal examination is a necessary examination step for the diagnosis of rectal cancer. About 80% of patients with rectal cancer come to the doctor. It can be found by natural rectal examination, with hard and uneven masses that can be palpable, and late-stage intestinal stenosis, fixed masses, and dirty pus and blood containing feces on the finger cots. Assuming that the doctor in the hospital where Mr. Zhuang was visiting at that time could tighten the string of rectal cancer and do a digital rectal examination, then the result would definitely be different. Or suppose that Mr. Zhuang has some common medical knowledge, and he should see a doctor in time and get a proctoscope or colonoscopy, which will make the diagnosis easier, and will not lose the best opportunity for surgery in the future.

    It should be emphasized that hemorrhoids can cause blood in the stool, but blood in the stool is not necessarily caused by hemorrhoids. It is generally believed that blood in the stool is caused by hemorrhoids, which is incorrect. Hematochezia usually occurs during defecation, dripping or jet-like bleeding during and after the stool, and the blood does not mix with the stool. Diagnosis of hemorrhoids is relatively easy, but it must be pointed out that clinically, anorectal diseases with blood in the stool such as rectal adenoma and rectal cancer are often misdiagnosed as internal hemorrhoids. Therefore, it is recommended that patients with blood in the stool must go to the anorectal specialist clinic for examination as soon as possible. Even a small digital rectal examination may determine the type of disease, especially excluding malignant diseases, otherwise it will delay the diagnosis and treatment of the disease. Will certainly leave a lifetime regret for myself and relatives.

    Anorectal Surgery Meng Qingcheng

    2013-03-08

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