1. What is anal fissure? What are the characteristics?
Answer: Anal fissure refers to a laceration in the anal area. It is a chronic disease that splits the skin of the anal canal longitudinally and forms infectious ulcers. Its characteristics are that it is prone to occur in young and middle-aged people. There are more women than men, and it usually occurs in the posterior median position of the anus. When anal fissure occurs, anal pain, bleeding, and constipation occur periodically. Traditional Chinese medicine is also known as "hook intestinal hemorrhoids", "slit anus" and other names.
2. What causes anal fissure?
Answer: The causes of anal fissure are mostly related to dampness, heat and blood stasis. Prolonged illness can easily lead to blood deficiency and body fluid deficiency, loss of intestinal nourishment, dry stool, damage to the anus, and anal fissure.
3. What are the manifestations of anal fissure? How to install? What will be found in the related inspections?
Answer: Anal fissures usually occur in the front and back center of the anus. The symptoms are mainly pain, bleeding, and constipation. Pain: It is cyclical, and the pain is aggravated during defecation, showing paroxysmal knife-like pain or burning pain. The pain decreases or disappears within a few minutes to more than ten minutes after defecation, which is called the pain intermittent period. Then there is severe pain, which often lasts for several hours before it is gradually relieved. In severe cases, coughing and sneezing can cause pain and radiate to the pelvis and lower limbs. Bleeding: Bleeding can be seen in the stool, usually the toilet paper is stained with blood or dripping blood, the blood is bright red, but the amount is small or only attached to the surface of the stool. Constipation: Patients often have habitual constipation. Dry feces often tear the skin of the anal canal and cause anal fissures, and because of fear of pain in the anus during defecation, they are unwilling to defecate regularly, which leads to prolonged retention of feces in the rectum and excessive water absorption. , Aggravate constipation and form a vicious circle.
Anal fissures are generally divided into two stages: early anal fissures-there is a small fusiform ulcer on the skin of the anal canal, the wound is light, bright red, the edges are neat and elastic, no scars or induration are formed, the course of the disease is short, and it is easy to cure . Old anal fissures-there is a history of repeated attacks of anal fissures. Early anal fissures have not been treated promptly and properly. The ulcers are pale in color, deep in the bottom, irregular wound edges, thickened like a "cylinder mouth", and flat in the bottom. The harder, gray tissues (comment band) have poor elasticity and are difficult to heal.
The examination revealed local cracks. The wounds of the early patients were fresh, superficial, red in color, soft and without fibrous tissue proliferation, and the wounds were grayish white, or dull, and hard in nature. The course of the disease was long around the wound and in the anus. Six kinds of pathological changes are formed at the tube and tooth line, including "cylinder mouth" thickening, combo zone thickening, connective tissue external hemorrhoids enlargement, anal hypertrophy papillae, subcutaneous fistula and anal sinusitis.
4. How should anal fissure be treated?
Answer: There are many treatment methods for anal fissure. If it is an early disease, constipation should be actively treated, keeping the stool smooth, protecting the ulcer wound, preventing infection, and most of it can be cured. Old anal fissures often require surgical treatment.
Blood heat and intestinal dryness syndrome: constipation, one line for 2-3 days, dry and hard, pain in the anus, stained or dripping blood on toilet paper, red in the mouth, with fullness of the abdomen, yellow urine, red tongue, yellow tongue coating Dryness, pulse number; treatment is mainly to clear heat and cool blood, moisten the intestines and laxatives. The prescriptions are modified by Zengye Chengqi decoction: Scrophulariaceae, Ophiopogon japonicus, Shengdi, Sanyu, Sophora japonica, Puhuang charcoal, honeysuckle, Forsythia , Yanhusuo, Maren, Quangualou and so on.
Yin deficiency and body fluid deficiency syndrome: dry stool, one line for several days, periodic anal pain, dripping blood, deep red cracks, irregular wound margins, dry mouth and throat, five upset heat, red tongue, little tongue coating or Yellow and greasy, pulse number; the main treatment is to nourish yin and clear heat, moisten the intestines and lax, and use Yiguanjian or Runchang Decoction as the prescription: Shengdi, Adenophora, Chinese wolfberry, bamboo leaves, angelica, hemp seed, peach kernel, Ophiopogon japonicus , Polygala, Quangualou and so on.
Qi stagnation and blood stasis syndrome: obvious anal tingling, especially after defecation, anus tightening, dark purple color, dark purple tongue, yellow tongue coating, stringy or astringent pulse; treatment is mainly for regulating qi, promoting blood circulation, removing blood stasis and dredging collaterals , Recipe selection of Liumo Decoction: betel nut, agarwood, woody, black medicine, rhubarb, citrus aurantium, dandelion, safflower, peach kernel, red peony, mirabilite, etc.
Fumigation and washing: Suitable for various stages of anal fissure. It has the effects of promoting blood circulation, removing blood stasis, reducing swelling and relieving pain. Commonly used, Sophora flavescens soup (60 grams of Sophora flavescens, 30 grams of Cnidium, 15 grams of Angelica dahurica, 30 grams of honeysuckle, 60 grams of chrysanthemum, Phellodendron amurense 15 grams, 15 grams of Kochia scoparia, 9 grams of calamus), Qudu Decoction (Sophora, Atractylodes, Scutellaria, Portulaca, Salvia, Astragalus, Hedyotis diffusa each 30 grams, 15 grams of safflower), 100 grams of Chinese pepper , 1:5000 potassium permanganate solution, etc., first smoke and then wash, can keep the local clean and hygienic, but also can promote blood circulation, reduce irritation, and accelerate healing.
Medication: Applicable to various stages of anal fissure, it has the effects of clearing away heat, detoxifying, relieving pain and stopping bleeding. Commonly used are Shengjiyuhong ointment, Huanglian ointment, Jiuhua ointment, etc., 1-2 times a day.
Suppository medicine: It is suitable for various stages of anal fissure, has the effects of clearing away heat and toxins, reducing swelling, relieving pain and stopping bleeding. Commonly used are hemorrhoid suppositories.
Corrosion: It is suitable for recurrent old anal fissures. It has the effects of promoting blood circulation, removing blood stasis, decaying and promoting muscle. Commonly used drugs are Baerdan, Qisandan, Hongshengdan, Kuzhisan, etc., or use 5% carbolic acid glycerin After rubbing the affected area, wipe it off with 75% alcohol. Main usage: Apply a small amount of pill on the old crack, 1-2 times a day, after the wound is fresh, use Shengji San to make the wound heal.
There are other surgical therapies (anal expansion, lateral sphincter incision, incision therapy, longitudinal section and transverse suture method), sealing therapy, etc.
5. How to prevent anal fissure?
Answer: To prevent anal fissure, we should develop good bowel habits, treat constipation in time, eliminate inflammation and avoid mechanical damage; the diet is mainly light vegetarian, eat more fresh vegetables and fruits, and avoid spicy foods; develop well Pay attention to the combination of work and rest, actively exercise to strengthen physical fitness; pay attention to keeping the anus clean and clean, and wash the anus in time after defecation to avoid infection; once the anal fissure is diagnosed, it should be treated as soon as possible to prevent secondary anal diseases; Local massage and moderate levator ani exercises are effective ways to prevent this disease.