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Chen Tian Jing
Colorectal Surgery
About me
Master's degree, specializing in research and treatment of colorectal surgery.
Proficient in diseases
Mixed hemorrhoids, internal hemorrhoids, external hemorrhoids, anal papillitis, perianal abscess, anal fistula, anal sinusitis, anal fissure, perianal abscess, pruritus ani.
Voices
How to eliminate the flesh balls of external hemorrhoids
External hemorrhoids primarily manifest as local skin tags or connective tissue protrusions, which may also be due to transient congestion and edema caused by acute episodes. If the hemorrhoids are skin tag-type or connective tissue-type and do not present any clinical symptoms or affect the patient's normal life, excessive treatment is generally not required. It is only necessary to maintain good dietary and defecation habits to prevent the condition from worsening. If the external hemorrhoids involve congestion, edema, or pain caused by thrombosis, complete removal can only be achieved through surgical excision. Merely using topical medications, applying heat, or using hemorrhoid creams can only reduce the size of the masses or alleviate symptoms, but cannot completely remove the masses.
How to reduce swelling of thrombosed external hemorrhoids
During the acute flare of thrombotic external hemorrhoids, the primary issue is the filling of the hemorrhoidal nucleus with blood clots, leading to congestion and swelling of the hemorrhoids. Due to edema or excessive pressure inside the hemorrhoidal nucleus, the patient may experience local discomfort or even severe pain. Therefore, the treatment of thrombotic external hemorrhoids first needs to reduce swelling. The methods mainly include local hot compresses, along with the oral administration of medicines that cool the blood, reduce swelling, and relieve pain. However, in some cases of thrombotic external hemorrhoids, where the blood clots are large or cannot be absorbed on their own after repeated attacks, surgery to excise the clots may be necessary to achieve the purpose of reducing swelling. During the acute flare of thrombotic external hemorrhoids, it is recommended that the patient seek medical attention as soon as possible to avoid complications such as repeated attacks or local blood supply disturbances, which could lead to necrosis of the external hemorrhoids.
Do internal hemorrhoids need treatment?
Internal hemorrhoids require active treatment. If not actively treated, internal hemorrhoids may prolapse and worsen, or bleeding may intensify. This can lead to severe local symptoms and potentially develop from early-stage symptoms that are mild, into more severe cases that may only be significantly improved through surgery. The treatment methods for internal hemorrhoids primarily involve the use of topical and oral medications. When prolapse or severe swelling occurs, patients can take oral medications that clear heat, cool the blood, reduce swelling, and alleviate pain, specifically for hemorrhoids. These should be combined with local anal suppositories for symptomatic treatment. For cases accompanied by bleeding, oral hemostatic medications can be administered. If the prolapse is substantial, or if the internal hemorrhoids cannot retract back into the anus, surgical removal is recommended. (The use of medications should be under the guidance of a doctor.)
Symptoms of perianal abscess
Perianal abscess is a common acute infectious disease in proctology. When a perianal abscess occurs, the patient generally experiences severe pain in the anal area accompanied by local skin redness, increased skin temperature, and even systemic fever and fatigue symptoms due to the local abscess. During an outbreak of a perianal abscess, the abscess cavity or pus encapsulation can generally be clearly seen under perianal color ultrasound, and it is necessary to promptly carry out perianal abscess incision and drainage surgery, as well as further one-time radical surgery for the perianal abscess. If not treated actively, a perianal abscess might rupture and likely form an anal fistula, the treatment of which is also primarily surgical.
The difference between perianal abscess and anal fistula
Perianal abscesses and anal fistulas both belong to local infectious diseases of the anus. A perianal abscess represents the acute phase of infection, characterized by significant localized subcutaneous swelling, heat, pain, and the formation of pus and abscesses. Once the pus breaks through the skin and discharges, it naturally forms an anal fistula. Anal fistulas represent the later stages or dormant phases of local infections. Both perianal abscesses and anal fistulas require surgical treatment. The surgical method for perianal abscesses mainly involves a one-time radical surgery for the abscess, while the surgical approach for anal fistulas primarily involves fistulotomy with seton placement, followed by regular wound cleaning and dressing changes post-surgery.
Can you drink beer if you have internal hemorrhoids bleeding?
During the bleeding phase of internal hemorrhoids, patients should not drink beer or other alcoholic beverages, nor eat spicy and stimulating foods such as chili peppers and seafood. This is because both drinking alcohol and consuming spicy, stimulating foods can cause the mucous membrane in the anal area to become congested. If there are any bleeding spots locally, the likelihood and volume of bleeding will be greater than normal. Therefore, further hemostatic treatment is necessary during the bleeding period. If alcohol is consumed, the volume of bleeding will increase and the severity of the bleeding condition will become worse. It is recommended that patients use external hemorrhoid creams for hemostasis, or take oral hemostatic drugs for symptomatic treatment. If the bleeding is substantial or the condition is not under control, further surgical treatment may be needed. (Please use medication under the guidance of a doctor.)
What should I do if there is pus draining from a perianal abscess?
When a perianal abscess occurs, there is typically pus or an enclosed abscess under the skin. If the perianal abscess ruptures and drains pus, it may have developed into an anal fistula. Once a perianal abscess forms an anal fistula, surgical treatment should be carried out as soon as possible. The surgical methods for treating perianal abscesses and anal fistulas mainly include incision drainage debridement surgery and incision with seton placement. After the surgery, due to substantial secretion from the local wound, it is essential to disinfect and change dressings regularly and to monitor the wound daily. It is crucial to prevent excessive granulation or pseudohealing at the local site, which could encapsulate the infection and prevent complete recovery, potentially leading to recurrence in the future.
Is the bleeding from internal hemorrhoids bright red?
The majority of internal hemorrhoid bleeding is bright red, but if there is a significant amount of bleeding, blood may accumulate within the anal canal and form clots, resulting in darker colored blood in the stool. To identify and diagnose whether it is bleeding from internal hemorrhoids, it is recommended that patients undergo an anoscopic examination. If obvious bleeding points are found near the mucosa around the dentate line, it is mostly due to internal hemorrhoids. To treat bleeding from internal hemorrhoids, it is first necessary to take oral or topical hemostatic medications for symptomatic treatment. If the internal hemorrhoid bleeding has been prolonged, or in cases of chronic blood loss, further surgical ligation may be necessary to stop the bleeding and prevent anemia due to excessive blood loss. (The use of medications should be under the guidance of a doctor.)
Can a perianal abscess be completely cured?
The primary cause of perianal abscesses is the repeated inflammatory stimulation near the dentate line of the anus, leading to infection. As the infection worsens, localized foci of infection form, resulting in the formation of pus and abscesses. Once a perianal abscess has formed, the patient will experience severe pain and will require prompt surgical treatment. If a definitive one-time surgery for the perianal abscess is chosen, it can be completely treated. Post-surgery, simply changing the dressing on the local wound will suffice, and the wound is expected to fully heal and recover. However, if an incision and drainage surgery was performed for the perianal abscess, a fistula may have already formed, requiring a second surgery for cutting and threading the fistula.
The difference between rectal prolapse and internal hemorrhoids prolapse
Rectal prolapse primarily refers to the prolapse of the rectal mucosa or part of the sigmoid colon mucosa, partially or completely falling out of the anus. Generally, there is a ring-shaped or cylindrical mucosa protrusion outside the anus. Internal hemorrhoid prolapse involves the partial prolapse of the mucosa near the dentate line, typically appearing as small lumps or accompanied by local venous thrombosis and varicose clusters, with rectal prolapse being more severe than internal hemorrhoid prolapse. The treatment of rectal prolapse mainly involves surgery, while early stages of internal hemorrhoid prolapse can be treated with medications. This involves using topical hemorrhoid creams or suppositories to alleviate symptoms. If there are recurrent prolapses or accompanying bleeding during bowel movements, surgical treatment may also be considered. Surgical methods for rectal prolapse primarily involve local mucosal ring excision, whereas surgeries for internal hemorrhoids mainly include hemorrhoid ligation or banding procedures.