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Yu Xu Chao
Colorectal Surgery
About me
Chief physician, master's degree graduate, engaged in colorectal surgery for six years, proficient in using integrated traditional Chinese and Western medicine to treat colorectal diseases.
Proficient in diseases
Has rich clinical experience in anal diseases, specializes in using a combination of Chinese and Western medicine methods to treat internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, anal fissures, anal fistulas, perianal abscesses, rectal prolapse, anal stenosis, constipation, inflammatory bowel disease, colorectal tumors, etc.
Voices
Can external hemorrhoids be eliminated?
External hemorrhoids can certainly be removed. Clinically, surgical treatment can be used to remove external hemorrhoidal masses. Hemorrhoidectomy is a common surgical option and can be performed under local infiltration anesthesia, spinal anesthesia, or general anesthesia. After surgery, it is crucial for patients to adhere to changing dressings to avoid infections, inflammation, or edema at the wound site. Dietary precautions should be taken as well; spicy, irritating, and dry foods should be avoided as much as possible. If patients prefer not to undergo surgery, medications can be considered for treating external hemorrhoids, though they can only reduce the size of the hemorrhoidal masses, not eliminate them entirely. Common treatments include anal washes and sitz baths, topical application of golden ointment, and when necessary, oral administration of Diosmin can help reduce swelling. Additionally, patients should regularly perform pelvic floor exercises and avoid prolonged or excessive straining during bowel movements.
What are the precautions after undergoing anal fistula surgery?
Because anal fistula surgery primarily involves removing the internal opening and the fistula tract, the postoperative wound is relatively large. Postoperative care mainly requires consistent dressing changes to ensure the wound drainage remains unobstructed, avoiding infection or false healing. Additionally, patients should develop good bowel habits, maintain smooth bowel movements, and avoid withholding stool. Otherwise, this may lead to dry, hard stools, causing severe pain during defecation or damaging the wound, which could result in bleeding or edema. In terms of diet, patients should choose foods rich in roughage to ensure smooth defecation and eat foods rich in high-quality protein to supplement the amino acids the body needs, promoting wound healing as much as possible. Moreover, after surgery, patients must use an anal wash or potassium permanganate solution for sitz baths. Since the postoperative wound is open and contaminated, changing dressings is especially important.
Can internal hemorrhoids be treated by prolapse and bloodletting?
Bleeding should not be used for prolapsed internal hemorrhoids, as this condition is primarily caused by improper defecation habits leading to pathological enlargement and descent of the anal cushion, which results in the prolapse of internal hemorrhoids. In the early stage, prolapsed internal hemorrhoids can retract back into the anus after defecation, and under such circumstances, it is only required for the patient to develop good bowel habits. For example, avoid spending too much time on defecation, don't exert excessive force, perform sphincter exercises after defecation, and maintain smooth bowel movements. Attention should also be paid to perianal hygiene; it is advised to wash the area with warm saline water after defecation to avoid worsening the prolapse or causing incarcerated edema. However, for cases where incarcerated edema occurs, it is generally recommended to consider prompt surgical intervention, such as hemorrhoidal ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Stapling Technique). The use of bleeding as a treatment does not have significant therapeutic effects for prolapsed internal hemorrhoids, and thus is not recommended in clinical practice. Furthermore, patients should pay attention to a light diet and avoid spicy, stimulating, and dry-hot foods as much as possible.
Does a recurrent perianal abscess occur in the same location?
The recurrence of a perianal abscess may not necessarily be in the same location, but it is possible. If the internal opening was not completely cleared during the first perianal abscess surgery, this could lead to reinfection of the anal glands and subsequently a recurrence of the perianal abscess. In such cases, it is advisable to visit a hospital early for a perianal MRI to determine the position of the internal opening and the extent of the infected tissue. Then, a one-time radical surgery for the perianal abscess can be performed. After the surgery, it is crucial to consistently use medications like red oil gauze, anal wash, and golden ointment for dressing changes, to promote wound healing and avoid pseudo-healing. Additionally, if a perianal abscess was completely cured once, poor diet, lack of sleep, or frequent alcohol consumption could potentially cause abscesses in other perianal areas later. This situation is quite common, so it is important for patients to maintain a light diet.
Has the perianal abscess that was drained a month ago and is neither painful nor itchy healed?
This situation often shows good post-operative recovery. Whether this situation is completely resolved depends on whether anal fistulas develop later, as most perianal abscesses drained can easily form anal fistulas. This is because drainage of perianal abscesses merely removes pus and secretions as much as possible, but does not completely clear the internal opening of the abscess and infected tissues. Thus, anal fistulas are likely to form later, and the patient needs to continue monitoring. Moreover, it’s important to maintain a light diet, avoiding spicy, irritating, and dry-hot foods as much as possible while also keeping bowel movements smooth. Frequent constipation or diarrhea should be avoided as they can cause wound pain or lead to inflammation and infection of the anal glands, potentially causing recurrence of the perianal abscess or the formation of anal fistulas later. However, the current situation indicates a relatively good post-operative recovery.
How to relieve pain and swelling from internal hemorrhoids prolapse?
Internal hemorrhoids prolapse with pain and swelling. This is often due to inflammatory edema or thrombosis caused by the prolapse, which leads to pain and swelling. At this time, you can choose to apply lidocaine gel externally or apply golden ointment externally for anti-swelling and analgesic effects. You can also choose to insert sodium diclofenac suppositories into the anus, which has anti-inflammatory and analgesic effects, and take diosmin tablets orally to relieve anal swelling, as well as use anal cleansers or potassium permanganate solution for sitz baths to eliminate local bacteria and secretions, and reduce local infectious inflammation. After using the medication, it is still recommended to go to the hospital's proctology department as soon as possible for treatments like internal hemorrhoid banding, PPH, or TST, because the swelling of prolapsed internal hemorrhoids indicates a severe condition, and mere medication alone cannot achieve effective treatment outcomes.
Mild bleeding due to internal hemorrhoids prolapse.
Internal hemorrhoids have prolapsed with slight bleeding. This is primarily considered to be due to pathological hypertrophy and descent of the anal cushions, causing the internal hemorrhoids to prolapse and the mucosa of the hemorrhoids to erode, leading to symptoms of rectal bleeding. For such cases, if the prolapsed internal hemorrhoids cannot spontaneously reduce, it is necessary to promptly adopt surgical methods such as hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). If the prolapsed hemorrhoids can spontaneously reduce, conservative treatment with medication may be temporarily used, such as applying compound preparations like mixed hemorrhoid suppositories or Jiuhua suppositories anally. Moreover, attention should be paid to a light diet, avoiding foods such as fishy seafood. It is also important to maintain smooth bowel movements; thus, eating less cold, hard food and avoiding difficult defecation that can lead to prolonged toileting times.
How to eliminate a perianal abscess mass?
Perianal abscess nodules are primarily caused by inflammatory infections that lead to local fibrosis, which then forms the nodules. For these nodules, it is recommended to employ a one-time radical cure surgery for perianal abscesses, mainly to remove the internal opening and the inflamed infected tissues. Since a perianal abscess can form a fistula after bursting on its own, failing to completely remove the infected tissue may lead to the development of anal fistulas later. Therefore, clinically, for perianal abscess nodules, it is advised to treat them with a one-time radical cure surgery for perianal abscesses. Post-surgery, medications such as anal washes and red oil ointment gauze strips are chosen for dressing changes. As for early-stage perianal abscess nodules, these are mainly inflammatory infections causing red and swollen lumps, which gradually turn into purulent and liquefied masses. Once suppuration occurs, they can be opened and drained, thereby causing the nodules to disappear. The nodules formed after incision and drainage are mainly considered to be from inflammatory spread to fibrotic tissue, and thus, surgical removal is required in these cases.
Can you have intercourse during an anal fissure?
During an anal fissure, it is possible to have sexual intercourse without any impact on the fissure itself. For patients with an anal fissure, the main focus should be on maintaining smooth bowel movements and avoiding dry and hard stools to prevent irritating the wound, which can cause pain and bleeding. It is also important to avoid diarrhea, as frequent bowel movements can irritate the wound over time and worsen the fissure. Clinically, for early-stage anal fissures, conservative treatment with medications is often recommended, along with softening the stool. Commonly used medications include Dragon Balm ointment or nitroglycerin ointment. After defecation, patients can opt to use an anal wash or a potassium permanganate solution for sitz baths. However, for chronic anal fissures, it is generally advised to undergo fissure excision surgery as soon as possible, followed by regular dressing changes to promote healing of the wound. If an anal fissure is left untreated for a long time, it can lead to slight narrowing of the anal canal, which requires significant attention.
Can internal hemorrhoids that prolapse be treated conservatively without surgery?
If internal hemorrhoids can be manually reduced after prolapse, then surgery can be temporarily avoided, and conservative treatment can be administered. For example, the patient should ensure smooth defecation, perform anal lifting exercises after defecation, strengthen the anal sphincter, and prevent the recurrence of internal hemorrhoids. Additionally, the duration of defecation should not be too long, and excessive straining should be avoided to prevent worsening of the prolapsed hemorrhoids. Moreover, patients must pay attention to the hygiene around the anus, and cleanse the peri-anal area with warm saline water after each bowel movement. However, if the internal hemorrhoids cannot be manually reduced after prolapse, or if incarceration and swelling occur, causing anal distension and pain, it is necessary to visit the hospital's colorectal surgery department promptly to undergo internal hemorrhoid ligation, TST, PPH, or other surgical procedures, followed by dressing changes. Since unresolved internal hemorrhoid prolapse can easily lead to incarceration or even necrosis, it is crucial to arrange for surgery as soon as possible, and patients should develop good bowel habits to maintain smooth defecation.