2021年1月26日星期二

hemorrhoids and anal fissures,Abnormal bowel habits and anal disease

    1. The anus is an important organ of the human body

    When it comes to the anus in life, it is often difficult for people to open their teeth. However, it is a very important part of the human body. In Chinese medicine, the anus is also called "Palmen", which is the five internal organs. "Shi" means envoy in ancient times, that is, the lesions of the five internal organs can be reflected in the anus. The anus has the function of controlling intestinal contents and defecation. The anus expands during defecation and shrinks naturally after defecation. With the discharge of gas (farts), no fecal residue will be brought out. This is because the anus has very good sensory control ability, and the closed anus can resist bacteria and foreign bodies outside the body. The effect of entering the human body is that the skin of the anus contains a large number of lymphocytes, and its self-cleaning ability and relaxation ability are unmatched by other parts of the human body. In addition, the structure of the muscles and blood vessels near the anus, that is, the pelvic floor, is very ingenious, and the coordination between each other has a good fixation effect on the body's abdominal organs. Without anus or poor anus function, it will give people life. It is a lot of inconvenience.

    2. Anorectal diseases are closely related to defecation, and even cause and effect each other.

    1. First, let us take constipation as an example and talk about the relationship between constipation and anal diseases.

    Constipation is not only one of the causes of anal fissure, but also a sequelae of anal fissure. Dry and hard stools discharged during long-term constipation may tear the anal flap and hypertrophic anal papilla, or damage the anal sinus and form an anal fissure. Once an anal fissure occurs, the pain during defecation is unbearable, which will lead to a "fear mentality". I would rather endure without defecation than experience pain during defecation. As a result, the stool has been endured for a long time, and the water in the stool is absorbed by the large intestine again, and the stool becomes dry and hard, and the pain caused by defecation again becomes more severe. Later, because of pain, I became more afraid of defecation... If things go on like this, a vicious circle will form, which will affect the healing of anal fissures and aggravate the condition.

    2. In addition, too long a bowel movement often occurs in our lives. What anal problems will it cause?

    Excessive defecation time can cause mixed hemorrhoids, internal hemorrhoids prolapse, and rectal prolapse. Vigorous defecation can also induce thrombosis and external hemorrhoids. Especially for people with cardiovascular and cerebrovascular diseases, excessive force during defecation is prone to accidents. When the hemorrhoids prolapsed after defecation are not sent back in time, it may often be accompanied by incarceration of internal hemorrhoids, causing redness, swelling and severe pain at the anal margin, which affects normal defecation.

    3. For middle-aged and elderly female patients, rectal protrusion is another important disease that we have to mention.

    Protrusion of the rectum, this disease, as the name suggests, is that the front wall of the rectum protrudes forward to the vagina, so that the front wall of the rectum forms a depression when defecation. During defecation, the stool is squeezed into the depression of the front wall of the rectum. After the force is exerted, the stool will move toward the vagina instead of the anus. As a result, it is difficult to make the stool pass through the anus with great effort. It is one of the "export obstructive constipation" and belongs to the category of "constipation" and "difficulty defecation" in traditional Chinese medicine, and it is more common in married and prolific women. At present, the cause of the disease is not clear, and the disease is mainly related to the abnormal anatomical structure of the rectum and vagina. The main manifestations are (1) Difficulty in defecation. Unlike constipation due to dry stool, women with protruding rectum may have difficulty in defecation, even if they are formed soft stools. In severe cases, they need to assist in defecation with their hands. (2) There is a feeling of falling in the rectum, a feeling of incomplete stool emptying, and the frequency of stools may increase. (3) Some patients have symptoms such as blood in the stool, anal pain, urinary incontinence, pain during sex. After suffering from the rectal protrusion, repeated struggling to defecate will further deepen the depression of the rectal protrusion, make the disease more and more serious, and cause greater pain to the patients and friends.

    Having said that, I want to tell you that the primary task of preventing anorectal diseases is to regulate stool. The bowel movement is normal, and many anal diseases are not easy to find you.

    3. So how do we regulate bowel movements?

    1. First of all, you should develop a good habit of regular bowel movements.

    The defecation time that meets the physiological requirements is to wake up in the morning or after breakfast, the previous night’s dinner was digested and absorbed by the stomach and intestines overnight, and the stool formed has resided in the sigmoid colon. Getting up in the morning produces a "standing reflex", which can increase the peristaltic wave of the colon, increase the pressure in the colon, and produce a defecation reflex. Breakfast fills the stomach and produces a "stomach-colon reflex". When colonic movement occurs large peristalsis, the internal pressure of the colon increases and defecation reflex occurs. Therefore, waking up in the morning and having a bowel movement after breakfast can increase abdominal pressure and smoothly pass stool. Therefore, it is necessary to develop good bowel habits.

    2. Pay attention to preventing constipation and avoid squatting in the toilet for too long.

    Overcome the bad habits of squatting for a long time to read, read a mobile phone, read a newspaper or smoke (smoking in the toilet can buffer the brain's defecation reflex and easily cause constipation).

    3. A healthy diet helps produce "good stools."

    Eat more fiber-rich foods every day, such as fresh fruits and vegetables, whole grains, etc. You can eat honey, black sesame seeds and other moisturizing foods in moderation; drink more water. Patients with non-diabetics can drink 1 cup of honey water (about 250ml) on an empty stomach every morning. Patients with anal diseases should especially avoid alcohol and spicy food.

    4. Sit bath with warm water.

    You can soak your buttocks in warm water for about 15 minutes a day to help promote blood circulation in the affected area. If you have anal pain and discomfort, you can also use pepper water to fumigate and bathe the anus for even better results.

    5. Anal exercises.

    For the elderly who are weak and the function of anal sphincter muscles decline, I will share with you an anal exercises today. The specific method is to lift and contract the anus forcefully, keep the contraction state to your limit, and then slowly and slowly relax the anus. It is recommended that each group do 20-30 retraction and retraction movements, and do 3 groups a day. The main point is to apply force quickly when lifting and contracting, and slowly when relaxing. This exercise is very simple and can be performed in various situations, such as waiting for the bus, riding in the bus, cooking, watching TV, etc., we can operate calmly. Don't underestimate this simple action. This anal exercise can not only enhance anal contractility, but also prevent a variety of anal diseases, and also help defecation. It's really killing three birds with one stone!

    6. Seek medical attention in time and actively treat.

    The clinical manifestations of various bowel abnormalities are different, and there are many pathogenic factors. Taking the most common constipation as an example, the classification and classification of constipation in both traditional Chinese and Western medicine are more complicated, and the treatment principles and methods of different classification classifications are quite different. These determine the importance of clinical classification and diagnosis of constipation. Only when the diagnosis of constipation patients is accurate and detailed, it is possible to choose the appropriate treatment plan.

    In modern medicine, there are some examination methods to determine the cause of constipation: such as digital rectal examination, anoscopy, proctoscope, electronic colonoscopy, colon transmission test, defecography, barium enema, anorectal pressure measurement, balloon Examinations such as forced tests, and special examinations such as basin electromyography or pelvic multiple radiography can be performed when necessary. Targeted examination can help clarify the cause of constipation, so as to treat the cause.

    Traditional medicine also advocates syndrome differentiation in the treatment of constipation. According to different types of constipation, the corresponding treatment methods are adopted. For example, Chinese herbal medicine treatment, acupuncture, auricular point application, abdominal massage, Qigong Daoyin, etc., have varying degrees of curative effect on the treatment of constipation.

    Regarding drug treatment, whether it is traditional Chinese medicine or western medicine, you should pay attention to: (1) Avoid long-term use of single-species drugs, take the medication intermittently, and change the type of medication appropriately according to the physical condition. (2) Use caution or avoid prolonged use of irritant laxatives containing phenolphthalein and anthraquinone, such as rhubarb-containing laxatives. Animal experiments have shown that long-term use of these drugs may cause irreversible enteric nerve damage and aggravate constipation.

    Most patients can be improved by changing their living habits and conservative treatment with drugs. Surgical treatment is a last resort treatment that is ineffective when conservative treatment is ineffective. For long-term severe constipation, if conservative treatment fails, surgical treatment can be selected as appropriate. Take the abnormal bowel movement caused by the rectal protrusion as an example. The principle of surgery is to repair the weak area of ​​the perineum and change the defects of the rectum during defecation. After the operation, you should continue to eat high-fiber foods, drink more water, and defecate regularly to avoid recurrence of constipation and aggravate rectal protrusion. In addition, severe hemorrhoids and anal fissures associated with abnormal bowel movements may also be treated with surgery.

    Let us regulate our stools, develop good bowel habits, and take care of our anus like our eyes! Because there are still two eyes.

    P.S. My visit time at St. Mark’s Hospital is every Wednesday. Welcome everyone to continue discussing anorectal related issues with me.

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