

Deng Heng

About me
Member of the Communist Party of China, attending physician in the Department of Anorectal Surgery, holder of a full-time Master's degree, published 2 SCI-indexed papers as the first author and several papers in Chinese core journals. Leading one Anhui Provincial Natural Science Foundation project, and one university-level research project at Anhui University of Chinese Medicine. Skilled in treating anorectal diseases using a combination of traditional Chinese and Western medicine.
Proficient in diseases
Hemorrhoids (including internal hemorrhoids, external hemorrhoids, mixed hemorrhoids), anal fissure, anal fistula, perianal abscess, anorectal sinusitis, cryptoglandular sinus, rectal polyps, anal itching, constipation, and other anorectal diseases.
Voices

Internal hemorrhoids bleeding is what color?
Rectal bleeding is the primary clinical symptom of internal hemorrhoids, typically characterized by bright red blood. Bleeding after bowel movements is one of the early symptoms of internal hemorrhoids, which often have no significant initial conscious symptoms, commonly presenting as blood-streaked stool after defecation. Bleeding after bowel movements can appear as dripping or spraying, bright red, painless, and not mixed with the stool. This distinction is crucial for differentiating from cancer. Rectal bleeding generally increases in severity over time, progressing from small amounts of blood to significant bleeding. Prolonged and repeated bleeding can lead to severe anemia in patients.

Can a twenty-year anal fistula turn into cancer?
Firstly, anal fistulas can become cancerous. Statistical data show that the probability of malignant transformation in anal fistulas is 1/1000, and such transformations are relatively rare in clinical practice. However, anal fistulas can change, but the timing of malignant transformation varies. Generally, the longer the duration of an anal fistula, the higher the chance of it becoming cancerous. The factors contributing to this transformation typically include chronic inflammation, long-term irritation, bacterial infection, and stimulation from medications, all of which can lead to cancerous changes.

Can excessive bleeding from internal hemorrhoids cause dizziness?
Excessive bleeding from internal hemorrhoids can lead to symptoms of dizziness. Bleeding is one of the main clinical manifestations of internal hemorrhoids. The amount of bleeding can vary, and the color of the blood is typically bright red. If there is a large amount of bleeding, lasts for a long time, or occurs frequently, and it exceeds the body's ability to produce new blood, it can lead to systemic anemia. Prolonged conditions can result in severe anemia, which may cause dizziness.

The main causes of anal fissures
The main causes of anal fissure formation may be related to the following factors: long-term constipation and hard stools, which cause mechanical damage during defecation as the direct cause for most anal fissures. It is also related to anatomical defects. Due to the superficial layer of the external sphincter forming a weak area at the back of the anal canal, dry stools exert the greatest pressure on the weak area at the back of the anus, making it prone to tearing injuries. Additionally, infection of the anal sinuses can lead to inflammation of the anal canal, and spasms of the sphincter losing its soft characteristics is also a reason for the formation of anal fissures. Furthermore, hard and dry fecal masses passing through the anal canal can easily cause tearing injuries, possibly due to the smaller size of the patient's anus.

Characteristics of anal fissure with bleeding
An anal fissure is a small ulcer formed by the full-thickness splitting of the skin of the anal canal below the dentate line. A characteristic of bleeding due to an anal fissure is that it generally occurs along with periodic, tearing-like pain. Thus, bleeding and pain are the main clinical manifestations of an anal fissure. During defecation, the damaged surface can lead to bleeding from the fissure, usually with a small amount of blood. The stool may have streaks of blood, or there might be a few drops of fresh blood after defecation, or a slight smearing of fresh blood on toilet paper during wiping.

How to treat thrombotic external hemorrhoids?
The treatment of thrombosed external hemorrhoids generally falls into two categories: first, conservative treatment; second, surgical treatment. Small lumps can be treated conservatively, and after 2-3 days, the thrombus can be absorbed, the pain can be significantly reduced, and self-healing is possible. However, larger lumps may erode on the surface, causing bleeding and severe pain that can impede walking and cause discomfort while sitting or lying down. In such cases, thrombectomy may be necessary.

What does an external hemorrhoid look like?
External hemorrhoids are hypertrophic protrusions of the skin around the anal margin, forming skin tags, or expansions of the subcutaneous venous plexus, where blood flow stagnates and thromboses form, or other raised lesion-like abnormalities appear. Based on histopathological characteristics, external hemorrhoids can be categorized into four main types: connective tissue-type, thrombotic-type, varicose-type, and inflammatory external hemorrhoids. Connective tissue-type external hemorrhoids primarily consist of hypertrophic protrusions of the anal margin skin tags, also known as skin tag external hemorrhoids. Varicose-type external hemorrhoids, also known as venous cluster-type external hemorrhoids, occur when the venous plexus below the dentate line expands and twists, forming venous clusters. Inflammatory external hemorrhoids are a condition where pre-existing skin tag external hemorrhoids develop inflammatory changes. Thrombotic-type external hemorrhoids are a type of anal disease that occurs due to bleeding from the hemorrhoidal veins or the formation of thromboses in the skin around the anus.

What should I do if internal hemorrhoids are bleeding?
The main symptoms of internal hemorrhoids are bleeding and protrusion, where the hemorrhoidal tissue prolapses outside the anus. There are several types of bleeding: the first is dripping blood during defecation, where blood drops steadily. Another type is spraying blood, similar to the way a syringe ejects fluid; these are all categorized under rectal bleeding. For internal hemorrhoids, the presence of either bleeding or prolapse outside the anus indicates a need for surgical treatment. This means that if internal hemorrhoids cause spraying blood, surgical treatment is required (i.e., removing the hemorrhoidal tissue), which can improve the bleeding and spraying issues.

Clinical manifestations of rectal prolapse
The main symptom of rectal prolapse is a swelling that protrudes from the anus. In the early stages, the swelling is small and only protrudes during defecation, retracting on its own afterwards. As the condition progresses, the protrusion occurs more frequently and grows larger, requiring manual assistance to push it back into the anus after defecation. This is accompanied by a feeling of incomplete bowel evacuation and a feeling of heaviness. If not addressed promptly, the prolapsed intestine may become swollen, constricted, incarcerated, and even risk necrosis. As the prolapse worsens, it can cause varying degrees of anal incontinence, accompanied by the discharge of mucus, which leads to eczema and itching around the anal area.

What department should I go to at the hospital for internal hemorrhoids?
Patients with internal hemorrhoids should go to the proctology department at the hospital, because internal hemorrhoids are venous clusters that grow above the dentate line of the rectum. The main symptom is rectal bleeding, along with prolapse, pain, anal itching, and a feeling of heaviness around the anus as the primary clinical manifestations. Proctologists have a good knowledge base about diseases around the anal area and are well-versed in diagnosing and treating internal hemorrhoids, as well as managing post-surgical recovery. Therefore, it is appropriate for patients with internal hemorrhoids to consult the proctology department after arriving at the hospital.