2021年11月14日星期日

Is anal pain and bleeding hemorrhoids or anal fissure during defecation?

Anorectal physician Xia Yan explained that anal fissure and hemorrhoids are different anorectal diseases. Hemorrhoids are venous masses formed by congestion, expansion and flexion of the venous plexus under the mucosa of the lower rectum and the skin of the anal canal. They are caused by pathological hypertrophy of the anal pad at the lower end of the rectum. Anal fissure is the surface crack of the narrowest anal canal tissue from the dentate line to the anal margin at the outlet of the digestive tract, forming a small ulcer. Constipation is an important cause of anal fissure.

Anal pain and bloody stool belong to the symptoms of hemorrhoids and anal fissure, but the biggest difference between the two is that hemorrhoids will produce hemorrhoids, which is to form a soft meat ball in the anus. External hemorrhoids can be touched, while internal hemorrhoids can be touched when they fall out of the anus; What anal fissure produces is not "meat ball", but ulcer and edema, and the pain is also more severe than hemorrhoids. So how do we usually distinguish between hemorrhoids and anal fissure? Xia Yan pointed out that they can be distinguished by their respective characteristics:

Characteristics of hemorrhoids

Internal hemorrhoids often do not have obvious characteristics at the beginning. Generally, they will show obvious symptoms in the later stage. With the continuous increase of hemorrhoids, the symptoms become more and more obvious.

Bloody stool. Hemorrhoids can cause intermittent blood in the stool, which is generally characterized by blood flowing down the anus drop by drop after defecation or blood on the stool paper.

Prolapse of hemorrhoids. Prolapse of hemorrhoids is generally the late symptom of hemorrhoids. Prolapse of hemorrhoids in the early stage can be held back by hand, but in the later stage, you can't push it back by yourself, there will be incarceration, and prolapse will occur when walking, sitting and standing.

Pain. In the early stage of internal hemorrhoids, only anal distension or difficult defecation were felt. However, if there is inflammation and swelling, thrombosis or incarceration in hemorrhoids, there is pain; If the prolapse is not reset in time, the pain will be aggravated; In case of incarceration, ulceration and necrosis, causing inflammation and edema of the skin around the anal margin, the pain is severe and the patient is restless.

Characteristics of anal fissure

Constipation. Most anal fissure patients will have constipation, mainly because of pain and dare not defecate, which will cause habitual constipation for a long time.

Pain. After suffering from anal fissure, going to the bathroom is a particularly painful thing. The tearing pain of sensitive parts becomes more and more painful with the discharge of stool. Some patients dare not defecate again when they are afraid. They always hold back and bear it, which leads to dry and hard stool. The more painful it is to defecate, and the more difficult it is to photograph it. This repeatedly aggravates the situation of anal fissure, and the vicious cycle continues, resulting in anal fissure difficult to heal, and even anal fistula.

3. Blood in stool: anal fissure is serious, and it will be painful and difficult to defecate. Forced defecation is easy to cause anal tear and bleeding. Blood in stool will be seen attached to the stool.

Changsha Dongda anorectal Hospital reminds anorectal diseases is a disease with higher incidence rate of life. When anal pain and bloody stool are present, it may not be caused by hemorrhoids. It may also be caused by other anal diseases such as anal fissure. But the specific one needs to be checked in a regular anorectal Hospital. We must not judge and treat blindly.

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