2021年2月2日星期二

hemorrhoids early pregnancy,Department of Anorectal, Nantong Hospital of Traditional Chinese Medicine: Questions and Answers on Common Anorectal Diseases

    1. Why is anorectal disease a common and frequently-occurring disease? Is the incidence of anorectal diseases clinically high?

    Clinically, the incidence of anorectal disease is very high. Moreover, the incidence of hemorrhoids is the highest among the anorectal diseases. So when ordinary people think of anorectal disease, they think of hemorrhoids. In fact, there are many types of anorectal diseases. Anorectal diseases refer to anal, rectal, and colon diseases, which are common and frequently-occurring diseases in daily life. The common saying of "ten people and nine hemorrhoids" among the people is enough to explain the problem. Anorectal diseases can be affected by both men and women, adults and infants, and the incidence is higher in women, especially women during pregnancy. The national census data shows that the incidence of anorectal diseases in adults is about 60-75%. The incidence of rural adults is higher than that of urban adults. Although less life-threatening, people with severe illness often affect their normal work and life. Even those with mild illnesses have to endure the pain of illness from time to time. Some babies suffer from anorectal disease, which not only affects their development and growth, but also causes a great burden on their parents. Therefore, we must pay attention to the prevention of anorectal diseases.

    2. Which diseases belong to the scope of diagnosis and treatment of anorectal department?

    Various diseases of the anus, rectum, and colon belong to the scope of diagnosis and treatment of the anorectal department. Common anorectal diseases include internal hemorrhoids, external hemorrhoids, anal fissures, anal fistulas, anorectal prolapse, internal prolapse, anal papilloma, rectal polyps, sacrococcygeal sinus, perianal perineal fasciitis, apocrine prolapse, etc. Etc. Colon diseases include ulcerative colitis, colon polyps, colon tumors and so on. In addition, such as anal eczema, pruritus, genital warts, anorectal malformations, etc. belong to the scope of anorectal diseases.

    3. Why are women more susceptible to anorectal diseases than men?

    In the census in 18 provinces, municipalities and autonomous regions across the country, it was found that the incidence of women was 13.1% higher than that of men.

    Why do women suffer more from anorectal diseases?

    This is because (1) In the process of life, women have more opportunities for pelvic organs to be oppressed and blood flow blocked, causing congestion and blood stasis in the pelvic organs, affecting blood circulation, and oppression of the rectum, which all induce anal diseases factor.

    (2) Menstruation and pregnancy can increase the burden on the anus. Some women often experience difficulty in defecation and prolonged intervals during menstruation or pregnancy, defecation once every 2 to 3 days.

    (3) In the late pregnancy, due to the enlargement of the fetus, the rectum is compressed, in addition to the difficulty of defecation, it also makes the rectal anus venous blood flow obstruction, which not only prone to hemorrhoids, but also makes the original hemorrhoids further aggravated.

    (4) The incidence of puerperium is higher. After delivery, due to the empty abdominal cavity, the sense of defecation becomes dull. In addition, the abdominal wall is loose, the activity is reduced, and the symptoms of defecation and difficulty in defecation increase. As a result, strong defecation will damage the anus and rectum. Cause anorectal disease.

    (5) In addition to the pregnant women mentioned above, when women reach menopause, their whole body muscles become loose and weak, and the tissues related to anal function such as sphincter, levator ani, puborectalis, etc. also become weak. At the same time, women tend to have menopause. The occurrence of endocrine and neurological dysfunction can make people irritable, have a sensation of defecation but not exhausted, and cause frequent visits to the toilet. It is also a factor inducing anorectal disease.

    4. What factors are related to common anorectal diseases?

    The occurrence of anorectal diseases is caused by a variety of factors, which can be divided into two categories: internal causes and external causes.

    Internal cause:

    (1) Anatomical factors: There are a lot of special structures in the anorectum, such as anal recesses, anal glands, anal papilla, rectal valve and special vascular structures. There is a lack of venous valves in the rectal veins, and blood tends to pool. The portal vein and the vena cava are located at the lower end of the rectum. There are many venous plexuses and anastomoses. The vein wall is weak, the resistance to pressure is reduced, and the submucosal tissue of the rectum is loose, which is conducive to the expansion of varicose veins and the formation of hemorrhoids.

    (2) Genetic factors: For example, due to genetic defects, genetic anorectal diseases such as multiple colonic polyposis can occur.

    (3) Abnormal embryonic development factors: the anorectum is formed by the fusion of the endoderm and ectoderm during the embryonic development of the human body. If the development process is abnormal, many congenital anorectal diseases can occur in the anorectum, such as congenital anus Disease, congenital rectovaginal (urethral) fistula, congenital megacolon, etc.

    External cause:

    (1) Poor defecation habits: When going to the toilet, squatting and reading the newspaper will cause the squat and defecation time to be prolonged. It is easy to cause blood stasis in the anus and rectum and induce diseases. Smoking while going to the toilet can buffer the brain's defecation reflex, which can easily cause constipation. Excessive force during defecation, some people, regardless of whether the bowel feeling is strong or not, blindly and constantly strive hard, which can only increase the unnecessary burden on the rectal anus and pelvic floor muscles and local blood stasis, leading to the occurrence and development of the disease.

    (2) Abnormal defecation: Diarrhea and constipation are both important pathogenic factors of anorectal diseases. Constipation is the biggest curse. Long-term retention of toxic substances in the rectum can not only induce rectal cancer, but also the accumulation of stool, which affects blood circulation. Exercising the dry fecal mass will inevitably cause a series of pathological changes such as blood stasis, swelling, and cracks in the anus. Diarrhea is often a clinical manifestation of colon disease. Diarrhea can also increase the chance of local anal infection, resulting in anal sinusitis, inflammatory external hemorrhoids, perianal abscess and other diseases.

    (3) Dietary factors: In daily life, it is natural that the dietary pattern or diet variety will inevitably change. For example, the quality of food, changes in vegetable types and quantity, the amount of protein, fat, starch, cellulose, etc., and water intake can directly affect the composition of stool and cause anorectal diseases. People who drink alcohol or eat spicy food for a long time, because alcohol and spicy food can stimulate the mucous membrane of the digestive tract, cause vasodilation, colonic dysfunction, and anorectal diseases. According to the national census data, the incidence of spicy food is 61.6%, and the incidence of drinking alcohol is 64.6%, which is significantly higher than the total incidence.

    (4) Occupational factors: standing or sitting for a long time. The anus and rectum lie in the lower part of the human body due to the upright or sitting posture, and the hemorrhoid veins are not smooth.

    (5) Chronic diseases: such as long-term malnutrition, weak physique, causing relaxation and weakness of the anal sphincter. Suffering from chronic bronchitis and emphysema for a long time, abdominal pressure rises due to cough and asthma, and pelvic blood stasis. Chronic hepatitis, cirrhosis, diarrhea, colitis, etc. are all triggers for anorectal diseases. Therefore, in the prevention, attention should be paid to the patient's general condition and reasonable and effective preventive measures should be taken.

    5. Blood in the stool is the most common symptom of anorectal diseases. Does the presence of blood in the stool indicate hemorrhoids?

    This is not the case. Blood in the stool is a symptom of hemorrhoids, but blood in the stool is not necessarily caused by hemorrhoids. For example, polyps, radiation proctitis, constipation, etc. may all have blood in the stool. It is especially important to remind everyone that rectal cancer may also have blood in the stool. So some people think it’s okay to have blood in the stool, but it’s actually very dangerous. As a specialist, the first thing to distinguish between hemorrhoids and rectal cancer is hemorrhoids. The blood in the stool of hemorrhoids is bright red, while the blood in the stool of tumors often has a feeling of falling, mucus, and is dark red. In fact, about 85% of rectal cancers The patient can be diagnosed through simple digital examination. Therefore, if there is blood in the stool, you should go to the hospital for examination in time to avoid delaying the condition. There are many lessons.

    5. Can you give some advice to patients about the health care of anorectal diseases?

    Answer: With the improvement of people's living standards, people pay more attention to health, quality of life and disease prevention. This is consistent with the concept of "preventing disease" in Chinese medicine. The prevention of anorectal diseases mainly include: 1. In terms of diet, do not have a partial eclipse and eat more fiber-containing things, such as celery, fungus, etc.; 2. Develop good bowel habits, some people take a book as soon as they go to the bathroom. A squat is half an hour, this habit is not good; 3. Do more exercise to avoid sitting for a long time. 4. Drinking plenty of water can relieve constipation. Of course, these need to be persistent for a long time.

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