Anorectal disease refers to a series of diseases related to the anus and colorectal. There are more than 100 common anorectal diseases, with a total incidence of 59.1%. There are more women than men in China and more men than women abroad. The common ones are hemorrhoids, anal fissures, perianal abscesses, anal fistulas, anal papilloma, rectal polyps, rectal prolapse, constipation, colorectal tumors and inflammatory bowel disease.
1. Classification and common symptoms of anorectal disease
Hemorrhoids: Hemorrhoids are masses formed by pathological hypertrophy, displacement of the anal cushion and stagnant blood flow in the subcutaneous vascular plexus around the anus. It is called hemorrhoids when it has clinical symptoms such as prolapse, blood in the stool, and pain. Hemorrhoids is the most common anorectal disease in China. Hemorrhoids can occur in people of any age, and it is more common in people between 20 and 40 years old, and the incidence gradually increases with age. Hemorrhoids are divided into internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids. Internal hemorrhoids are divided into stage I hemorrhoids, stage II hemorrhoids, and stage III hemorrhoids; external hemorrhoids are divided into: inflammatory external hemorrhoids, thrombotic external hemorrhoids, varicose external hemorrhoids, and fibrotic external hemorrhoids. Different types of governance are different.
Anal fissure: Anal fissure means that the skin of the anal canal splits and forms ulcers. Clinically, it is dominated by periodic pain in the anus, blood in the stool, and constipation. It has the characteristics of repeated attacks, difficulty in healing, and gradually becoming chronic. Generally seen in young adults between 20 and 40 years old, the occurrence of anal fissure is usually closely related to anatomical defects of the anal canal, excessive force during defecation, dry stool and other factors, but it can also be secondary to ulcerative colitis and granulomatous colon Inflammation, tuberculous ulcer, syphilis, hematological malignancy, etc.
Perianal abscess: Perianal abscess refers to acute purulent infection and abscess that occurs in or around the soft tissues around the anorectum. This disease can occur at any age, but for young adults between 20 and 40 years old, males are higher than females. It has the characteristics of sudden onset, severe pain, accompanied by fever, and anal fistula often formed after ulceration or incision and drainage of pus.
Anal fistula: Anal fistula refers to an abnormal passage formed by the anal canal or rectum due to pathological reasons with the adjacent skin or tissues around the anus. It is generally composed of a primary internal opening, a fistula, and a secondary external opening. The main clinical manifestations of this disease are recurrent pus discharge, swelling and pain near the anus. It mostly occurs in young adults, and the male to female incidence ratio is 5:1. Most of the causes are related to anal gland infection. If long-term treatment does not heal, complex anal fistulas or cancer can occur.
Anal papilloma: It is inflammation and edema of the anal mastoid at the lower end of the rectal column, which grows and grows over time, forming a tumor-like mass. Generally benign, but can become cancerous.
Rectal polyp: It is a bump that protrudes from the mucosal surface of the large intestine into the intestinal cavity. It mostly occurs in the rectum and sigmoid colon. More than 90% of adenomas are distributed in the rectum and have a high tendency to become cancerous. Statistics show that 40%-50% of cases can be transformed into adenocarcinoma.
Rectal prolapse: Rectal prolapse refers to a disease in which the rectal mucosa, full thickness of the rectum, anal canal and even part of the sigmoid colon move downward and prolapse outside the anus. With the improvement of people's living standards, this disease is less common in cities. The disease can occur in all ages, but it is more common in young children, postpartum women, and the elderly and infirm.
Constipation: Constipation is a group of symptoms that can be caused by a variety of diseases, including low stools, hard stools, difficulty in defecation, prolonged defecation, anal swelling and blockage, feeling of incomplete stool, with or without abdominal pain, bloating, nausea, Symptoms such as blood in the stool and irritability. From the etiology can be divided into organic and functional. At present, according to the location and motility disorder of defecation difficulty, it is recognized internationally that it is divided into three types, namely slow transmission type, outlet obstruction type, and mixed type.
Inflammatory bowel disease: Inflammatory bowel disease is a chronic non-specific intestinal inflammatory disease for which the etiology is not well understood, including ulcerative colitis and Crohn's disease. The former is a chronic non-specific inflammation of the colon. In severe cases, ulcers and cancer can occur. The main clinical manifestations are diarrhea, abdominal pain and mucus pus and blood in the stool. While Crohn's disease is a chronic granulomatous inflammation, the main clinical manifestations are abdominal pain, diarrhea, fistula, anal lesions and varying degrees of systemic symptoms.
Colorectal cancer: Colorectal cancer is a malignant tumor that occurs in the colorectal. It is the fourth most common malignant tumor in China, and its morbidity and mortality have a tendency to increase year by year. In a sample survey of one-tenth of the Chinese population from 1990 to 1992, the average death rate from colorectal cancer was 4.54 per 100,000 population, ranking fifth among cancer deaths.
2. The characteristics of anorectal diseases
The incidence of anal disease is mostly adults. The incidence is related to sedentary, long standing, low activity, constipation, diarrhea, long defecation time, drinking, and a preference for spicy food. The incidence of women is higher than that of men, and the incidence of internal hemorrhoids is the highest.