2021年1月25日星期一

what does a hemorrhoids look like,The story of blood in the stool

    There are not many patients coming to the outpatient clinic today, so I was puzzled: this sunny day and cloudless weather should be a good day for medical treatment. Why are there so few patients? "Men Ke Luo Que" is not the usual outpatient style of our doctor!

    Just when I was about to enter (shui) (zhao) leisurely, a young male patient in his 20s came with a nervous look.

    "Today I pulled out a lot of blood in my stool

    Will you get bowel cancer? "

    I saw his ruddy complexion, strong body, and a little fat baby, I probably had the answer in my heart.

    After the digital anus examination, no rectal lesions were found, but there were a few internal hemorrhoids, probably bleeding from hemorrhoids.

    Seeing that the time is still early and there is no appointment for the patient later, I decided to have a good chat with him.

    So I pretended to be an old Chinese medicine doctor and asked some questions:

    Is it blood?

    Is it bright red blood or dark red blood?

    Was it pulled out with the stool, or pulled the blood alone?

    Was it dripping or was it shot?

    Do you pull blood frequently, or do you pull it every so long?

    How much blood comes out?

    Are there blood clots?

    Are there any other discomforts besides blood in the stool?

    Does anyone in the family have intestinal tumors?

    Do you usually have constipation?

    Do you have a lot of bowel movements?

    Is there any thinning or indentation in the stool?

    Does the stool contain mucus?

    The young man looked confused:

    "Sorry, I didn't hear clearly

    Can you ask one by one? "

    Well, I have plenty of time today, so I will explain them one by one.

    Is it blood?

    Many times the stool is red, but not necessarily blood!

    This may be related to the food you eat, such as watermelon, pig blood, amaranth, red dragon fruit and other red foods, the stool may become red; and some red drugs, such as rifampin, may also cause stool to become red. Red.

    Therefore, sometimes in order to determine whether it is blood, it is necessary to take the stool to check and do a stool occult blood test.

    Is it bright red blood or dark red blood?

    The blood that has just flowed out of the diseased tissue is bright red, but when the blood is deposited for a period of time, especially after mixing with the digestive juice, the blood will turn dark red.

    In this way, the location and amount of bleeding can be roughly judged.

    ⚫Bleeding from lesions in the lower rectum or anus (tumor, hemorrhoids), because the bleeding is quickly discharged from the anus, and the blood is usually blood.

    ⚫Bleeding from the small intestine or colon. If the amount of bleeding is not large, the discharged blood may be dark red; bleeding from the esophagus and stomach in the upper gastrointestinal tract, because it is mixed with the digestive juice, the discharge is darker, sometimes like asphalt, called tarry Poop.

    ⚫If it is heavy bleeding, such as several hundred to thousand milliliters of blood at a time, it is difficult to judge, because the amount of bleeding is large and fast, and it is too late to deposit in the digestive tract, and the blood drawn out is bright red.

    Was it pulled out with the stool, or pulled the blood alone?

    Usually the blood is pulled out together with the stool, and normal stool can be seen. We call it bloody stool. In this case, the amount of bleeding from intestinal lesions is usually not large, and some blood comes out only when stool.

    If you pull the blood alone, the amount of bleeding will be relatively large. Because more blood fills the rectum, a large amount of blood stimulates the rectum and anus to produce bowel movements and pull blood.

    As mentioned earlier, the blood drawn here will have different colors depending on the location of the bleeding.

    Was it dripping or was it shot?

    The amount of blood dripping out is smaller than the amount of bleeding that comes out of an injection.

    Do you pull blood frequently, or do you pull it every so long?

    Frequent pulling blood (less than 1 hour apart) may cause heavy bleeding, or bleeding from lesions of the distal colon, rectum, or anus.

    Because there is an ileocecal valve obstruction between the small intestine and the colon, it acts like a valve to control the discharge of intestinal contents to the colon. All upper gastrointestinal and small intestinal bleeding may be pulled every time (several hours).

    When the amount of colorectal bleeding is not large, it will accumulate in the rectum until a certain amount is discharged, and the blood may be patted every long time.

    How much blood comes out?

    This is a key issue, including how many pulls and how many pulls at a time. If there is a bleeding of more than 800ml (about three rice bowls), even if it is bleeding, shock may occur.

    Are there blood clots?

    Bleeding in the upper gastrointestinal tract or small intestine, because of the mixed digestive juice, the blood is in a non-coagulated state and is liquid; or mixed with the intestinal contents and is tarry.

    Bleeding from the rectum or the distal colon, blood collects in the intestinal cavity, because there is not much intestinal fluid affected, the blood self-coagulates after a period of time, and a large number of blood clots appear.

    Are there any other discomforts besides blood in the stool?

    Upper gastrointestinal bleeding is sometimes accompanied by nausea, vomiting, and hematemesis. Biliary tract and pancreatic bleeding may cause abdominal pain, acute hemorrhagic necrotizing enteritis may also be accompanied by diarrhea, and anal disease may be accompanied by anal pain.

    But in many cases, blood in the stool comes suddenly, and there is no other discomfort except for dizziness. Therefore, gastrointestinal bleeding is an intractable disease in general surgery and gastroenterology!

    Also, does anyone in the family have intestinal tumors, whether they have constipation, frequent bowel movements, changes in stool shape, stools with mucus, etc. These are all related to the family history, stool habits, and changes in traits related to colorectal tumors. These problems may be bleeding caused by colorectal tumors (polyps or malignant tumors)!

    Think there are only so many?

    If you think about it carefully, it's really complicated!

    After finishing talking, the young man nodded as if he didn't understand

    "Yep

    I am blood

    Not much bleeding

    No disease in the rectum

    That should be bleeding from hemorrhoids. "

    Haha, he understands!

    I happily prescribed some hemorrhoid medicine for plugging the anus, and instructed him to eat lightly, drink plenty of water, eat more vegetables and fruits during this time, and keep his stool smooth. If he still bleeds repeatedly, come to see the doctor again.

    More medical science knowledge of doctors can be obtained by clicking here!

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