2021年2月18日星期四

hemorrhoids bleeding treatment,Introduction to clinical symptoms of hemorrhoids and fistula and new minimally invasive treatment techniques

    Special Program of "Healthy Clan" on Zhongshan Radio

    Question: Moderator, answer: Chen Jinquan.

    1. What is hemorrhoid fistula disease?

    Answer: Hemorrhoid fistula disease is the general term of the five major anal diseases of the motherland medicine for hemorrhoids, anal fissures, perianal abscesses, anal fistulas, and prolapse of the anus. As early as the Warring States period more than 770 BC, our medical scientists proposed "hemorrhoids." The name of "fistula" is still in use today. Since hemorrhoids and anal fistula are the most common clinically, the four major anal diseases of hemorrhoids, fistulas, cracks and prolapse have been referred to as hemorrhoid fistula diseases since ancient times.

    2. Q: What are the symptoms of hemorrhoidal fistula disease?

    Answer: The following focuses on the clinical symptoms of hemorrhoidal fistula disease.

    Hemorrhoids are mass-like masses that grow inside and outside the anus of the human body, which are formed by the lowering of the anal cushion, varicose veins, connective tissue hyperplasia, or skin tags.

    2. Q: What are the symptoms of hemorrhoids?

    Answer: Hemorrhoids are divided into three types: internal, external and mixed. Different types of hemorrhoids have different symptoms.

    1. First, light internal hemorrhoids. Hemorrhoids occur about 1 to 3 cm inside and outside the anus of the human body. Blood in the stool is the main symptom of internal hemorrhoids. Early internal hemorrhoids mainly include blood in the stool or dripping blood. Large internal hemorrhoids can cause ejection. Internal hemorrhoid bleeding is characterized by painlessness and bright red blood. If constipation occurs, blood in the stool is accompanied by anal pain, it may be anal fissure bleeding.

    2. Anal mass prolapsed. In the early stages of internal hemorrhoids, there is no prolapse of internal mass in the anus, and prolapse of hemorrhoids means that the internal hemorrhoids have developed to the middle or late stage, and the symptoms are serious. Moderate internal hemorrhoids can retract into the anus by themselves after defecation, while severe internal hemorrhoids need to be sent back into the anus by hand after defecation.

    3. The main symptom of external hemorrhoids is the swelling of anal skin tags. When inflammation or thrombosis occurs, the anus may have obvious pain. Older male patients may have symptoms of dysuria if they have an enlarged prostate. The swelling and pain of hemorrhoids makes the patient restless and difficult to move. Therefore, there is a saying among the people that "hemorrhoids are worse than serious illnesses." When hemorrhoids are complicated by infection, it can cause symptoms such as itching, dampness, and fluid leakage in the anus.

    4. Q: What is anal fistula?

    Answer: Anal fistula is a sequelae of perianal abscess and one of the more common anorectal diseases. The age of onset of anal fistula can be as young as a baby who is only a few days after birth, or as large as 70-80 years old. Perianal abscess is a disease in which purulent infection of the anorectal tissues occurs due to bacteria, trauma, etc. of the anus and rectum. When the abscess is punctured by itself or after surgery is simply incised to drain the abscess, the abscess cavity shrinks, and the anal wound is not repeated afterwards. Anal fistula after healing.

    5. Q: What are the symptoms of anal fistula?

    Answer: The main symptom of anal fistula is that after the perianal abscess is ruptured, the anal wound repeatedly swells, pains and discharges pus. In severe cases, symptoms such as local redness, swelling, heat and pain, or fever and discomfort may occur. Check one or more openings around the anus, where pus is exuded under pressure, and the hard tube connecting the cord-like mass with the anus can be palpable under the lesion.

    6. Q: Why is it difficult for anal fistula to heal naturally?

    Answer: The reason why an anal fistula is difficult to heal naturally is that there is an infected internal mouth in the anus. There are a large number of bacteria and feces in the anal canal and rectum and enter the inside of the anal fistula through the internal opening. There are a lot of necrotic tissues in the wall, and the antibacterial drugs cannot enter the fistula to kill bacteria and other reasons, so that most people cannot heal naturally once they suffer from anal fistula.

    7. Q: What are the adverse effects of hemorrhoidal fistula disease on the human body?

    Answer: If hemorrhoids and anal fissure have repeated long-term heavy bleeding, severe anemia can be caused. Causes the patient to appear pale, dizzy, lack of energy, difficulty in defecation, hair loss, memory decline, and cause the human body to appear old age first, and decline in disease resistance. Hemorrhoidal fistula swelling and pain will affect the human body, work, life, rest and health. Individual patients with severe hemorrhoidal fistula may even develop cancer.

    8. Question: I heard that anorectal cancer is also easy to cause anal bleeding. How do I know if it is bleeding from hemorrhoids or rectal cancer?

    Answer: Anorectal cancer refers to malignant tumors that occur in the anorectal area. In recent years, colorectal tumors have increased and become younger. According to our department’s electronic colonoscopy data, about 70% of human colorectal cancers occur in the anorectal area. The main early symptoms are accidental bleeding from stool, blood in the stool, and anal volume. It is easier to cause hemorrhoids and anal fistula bleeding. Confusion, it is easy to be misdiagnosed as diseases such as hemorrhoids, anal fistula or colitis. Some hemorrhoid fistula diseases are associated with colorectal cancer. For example, there was a recent patient with bleeding from stool and diarrhea for 4 months. The patient went to a specialist to treat hemorrhoids. The symptoms did not disappear. Instead, bloody stool and diarrhea increased from 4 times a day to more than 20 times a day. The anus was tense and heavy, and weight lost. After a colonoscopy in our department, it was found that it was advanced rectal cancer, and the intestinal cavity was very narrow. None passed. The prognosis of the patient is very poor and the lessons are very profound. It is not difficult to distinguish hemorrhoids from bleeding from rectal cancer. As long as you go to the hospital to perform some simple digital anal examinations and then perform an electronic colonoscopy according to the condition, you can diagnose hemorrhoids or colon cancer bleeding.

    9. Question: Which hemorrhoids need surgical treatment?

    Answer: Generally speaking, mild hemorrhoids do not require surgery. However, timely surgical treatment should be considered in the following situations.

    1. After taking medicine or internal hemorrhoid injection treatment, hemorrhoid bleeding is still obvious or the bleeding cannot be controlled;

    2. Hemorrhoids often prolapse, swelling and pain, causing adverse effects on work, life and students.

    3. Hemorrhoids often, erosion, exudation, or accompanied by obvious anal papillomas may worsen.

    10. Q: I heard that the traditional treatment of hemorrhoids is more painful. What new techniques are there for hemorrhoids?

    Answer: The anus is the gate for the body to control stool and gas discharge. Its function is very important and it is very sensitive. Hemorrhoids grow on the anus. How to solve the pain of hemorrhoids and fistula patients while trying to protect the function of the anus and reduce the pain of the surgical patients, and avoid the occurrence of serious complications is an important task and topic for our anorectal medical staff. According to our years of exploration and observation, Minimally invasive surgery for hemorrhoids is an ideal method for the treatment of moderate to severe hemorrhoids.

    There are two main methods for minimally invasive treatment of hemorrhoids. One is the treatment of hemorrhoids by a small incision + suture and ligation. Make a purse-string ligation for the middle part of the hemorrhoids, and then remove and anastomize the hemorrhoids all at once cleanly and automatically. If there are external hemorrhoids, perform appropriate excision treatment to make the internal and external hemorrhoids disappear instantly and achieve the purpose of curing hemorrhoids. Compared with traditional external resection and internal ligation, the above two new minimally invasive treatments for hemorrhoids have the following three advantages (1) The postoperative pain is relatively light. (2) Heal faster. (3) Postoperative complications and sequelae such as anal stenosis and anal incontinence are not easy to occur. It can immediately relieve the suffering of blood in the stool and prolapse of hemorrhoids. Therefore, it is quite popular with patients.

    11. Question: We just talked about the symptoms of hemorrhoids and the treatment of micro-innovative technology. Now I invite Director Chen to introduce the treatment of anal fistula.

    Answer: In the past, the traditional method of treating anal fistula, especially high complex anal fistula, was to use incision and thread-drawing method. The disadvantage of this method is that the incision is large and the postoperative patients are more painful. After the operation, it is easy to suffer from incomplete anal incontinence and anal defects, so that some patients with anal fistula dare not treat anal fistula.

    In recent years, we have explored an ideal new method of minimally invasive resection with sutures or no sutures to treat anal fistulas, and achieved remarkable results. This new operation can completely cure the diseased tissue of anal fistula, while protecting the function of the anus to control stool and the integrity of the anus to the greatest extent, and the patient has a small postoperative wound. Therefore, the patient suffers less pain, heals quickly, and has a high cure rate. There are no complications and sequelae such as anal incontinence and obvious anal defect. It can be discharged 20-30 days earlier than traditional thread-attaching treatment, which can save a lot of medical expenses and is very sick. Welcome.

    12. Question: How can we stay away from hemorrhoids and fistula disease?

    Answer: To keep oneself away from hemorrhoids and fistula diseases, the key is to prevent and avoid the adverse factors that cause hemorrhoids and anal infections and abscesses, such as constipation, diarrhea, unclean anus, anal fissure, and struggle to defecate. Patients should usually follow 4 aspects to prevent hemorrhoids:

    1. Keep stool smooth. Hard stool can not only scratch the hemorrhoids and cause bleeding, but also easily cause the hemorrhoids to loosen out of the anus, or cause acute incarceration, leading to sudden swelling and pain of hemorrhoids.

    2. Keep the anus clean. There are many folds in the anus. No matter how to wipe the anus with the toilet paper, the residual feces adhering to the anal folds cannot be completely removed. It is easy to be complicated by perianal infection, causing perianal abscess and anal fistula. Rinse the anus with water after the second bowel movement to keep the anus clean and reduce local inflammation.

    3. Eat less spicy and stimulating foods. Spicy and stimulating foods and wine can easily cause hemorrhoids, congestion and edema, and cause bleeding. Therefore, patients with hemorrhoids should eat less or not spicy food.

    4. Frequent levator ani exercises. Regular contraction or relaxation exercises on the anus can promote local blood circulation in the anorectal area, improve the elasticity of anal sphincter, and avoid or reduce the degree of hemorrhoids prolapse.

    5. Once anorectal diseases such as hemorrhoids, anal fissure, perianal abscess, anal fistula, prolapse, diarrhea, constipation, etc. occur, you should consult a shallow Chinese medicine practitioner and go to the relevant specialist hospital for examination and treatment in time.

    Moderator: Dear listeners, the time is almost up. This issue of the "Healthy Clan" program-"Introduction to Clinical Symptoms of Hemorrhoids and New Techniques for Minimally Invasive Treatment" will be introduced here. See you next time. Thank you for listening.

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