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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
Hemorrhoids bleeding examination what
Hemorrhoid bleeding is mainly due to the rupture of local hemorrhoid mucosa or bleeding from local small arteries caused by repetitive friction and irritation. If the mucosa bleeds, the bleeding generally manifests as minor seepage; however, if small arteries rupture, the bleeding appears as dripping or squirting. To examine hemorrhoid bleeding, an anal digital examination and an anoscopy must be conducted to determine the exact location of the bleeding and the amount of blood loss. Based on the examination results, an appropriate treatment plan can be selected. For minor bleeding, local application of hemostatic creams or oral hemostatic medications can be considered. If the bleeding is more significant, appearing as dripping or squirting arterial pulsatile bleeding, it is recommended to perform ligation to stop the bleeding.
Can a perianal abscess heal by itself?
During the acute phase of a perianal abscess, there is significant local redness, swelling, heat, and pain around the anus. Generally, this condition is caused by an infection of the anal crypts, and the possibility of self-healing is very low, so the main treatment for a perianal abscess is surgery. The surgical approach usually involves incision and drainage of the perianal abscess, combined with a one-time curative surgery. If the abscess ruptures and forms an anal fistula, surgical treatment is also required. During the outbreak of a perianal abscess, due to the severe local pain, it is advisable to undergo surgery as soon as possible to prevent further spread of the abscess. Simple topical medications can only relieve the symptoms of local inflammatory infection and cannot achieve a cure.
Can an anal abscess be cured by taking medicine?
An anal abscess is formed due to repeated infections within the anal crypts, resulting in localized pus or an encapsulated abscess. During an episode, the patient experiences severe pain, strong positive tenderness, and notable swelling, heat, and pain around the anal area. In severe cases, it can affect normal sitting and even walking activities. When an anal abscess occurs, it generally requires prompt surgical incision and drainage followed by definitive surgery. Relying solely on oral or topical medications cannot completely cure an anal abscess and only serves to alleviate symptoms. Post-surgery for an anal abscess usually involves local dressing changes to prevent pseudohealing and maintain proper drainage of the wound.
How to relieve pain from anal fistula?
The main reason that anal fistulas cause pain is because they are severe infectious lesions. During the acute phase, local inflammation causes pain or itching around the external opening, along with discharge from this opening. To alleviate the pain caused by anal fistulas, one can first apply anti-inflammatory ointments to temporarily relieve the symptoms. It is also important to maintain cleanliness around the anal area. Hemorrhoid suppositories can be used to ease the inflammation in the anal and intestinal tract. However, to completely cure the pain from anal fistulas, besides conservative medication, surgical treatment is often necessary. The main surgical method for anal fistulas is fistulotomy with a seton placement, which thoroughly removes the local infection and prevents the recurrence of pain.
How to treat internal hemorrhoids?
Hemorrhoids are divided into internal, external, and mixed types. The clinical symptoms of internal hemorrhoids mainly include local pain, prolapse, and rectal bleeding due to rupture. If there are recurrent episodes or associated inflammation, there may also be an increase in secretions, which can irritate the local skin around the anus and cause itching. Therefore, the primary treatment for internal hemorrhoids involves the use of suppository hemorrhoid plugs. If there is accompanying bleeding, it is also necessary to combine this with oral hemostatic medications. In cases of perianal itching, options such as sichuan pepper water or other insecticidal and anti-itch traditional Chinese medicine washes can be used for fumigation and hot compresses on the affected area.
What should I do if anal fissures keep recurring?
Repeated episodes of anal fissure generally result in the formation of chronic anal fissures. The fissure in chronic anal fissures mainly presents as an ulcer surface, and because the fissure is enclosed within the local sphincter muscles, drainage is poor, thus reducing the likelihood of healing. When patients with anal fissures suffer from long-term recurrent episodes, they also experience spasms of the local anal sphincter and tightening of the anal canal, which can lead to difficulties in bowel movements and dry stools in the anal region. When the spasm of the local anal sphincter worsens, the pain may cause patients to be afraid of defecating voluntarily, thereby creating a vicious cycle of recurrent episodes. The best treatment for recurrent chronic anal fissures is surgical intervention.
Can glycerin suppositories be used for rectal prolapse?
If a patient experiences difficulty in defecation or constipation due to rectal prolapse, enemas can be used to help facilitate bowel movements. The basic principle behind the defecation difficulties caused by rectal prolapse is due to the prolapsed, lax mucosa blocking the anal opening, preventing normal excretion of stool. Alternatively, when excretion does occur, it may be impeded by the mucosal obstruction, obstructing the normal passage of feces. Therefore, besides using enemas to address difficulty in defection and bowel movement, it is more necessary to surgically remove the lax mucosa to achieve a fundamental treatment. The use of enemas alone can only provide temporary relief of symptoms and does not address the root cause of the problem. For rectal mucosal prolapse, a stapled hemorrhoidopexy can be performed to surgically remove the prolapsed mucosa.
Can you do yoga with rectal prolapse?
Patients with rectal prolapse can engage in moderate exercise, but it is not recommended to perform exercises that involve significant abdominal strength or squatting movements. This is because excessive abdominal pressure or overexertion can increase intra-abdominal pressure, compressing the mucosa and tissue around the anus, thereby worsening the prolapse. If squatting exercises are performed over a long period, it could further aggravate the degree of rectal mucosal prolapse. Hence, patients with rectal prolapse may opt for gentler exercises like yoga, ensuring that the movements and methods do not exacerbate the condition of the rectal mucosa. Patients with rectal prolapse should seek surgical treatment as soon as possible, where the prolapsed mucosa is completely excised for recovery.
Will thrombotic external hemorrhoids turn cancerous?
Thrombosed external hemorrhoids are a common clinical symptom of external hemorrhoids. The pathogenesis mainly involves the formation of blood clots inside the hemorrhoidal node, which is primarily due to local circulatory disturbances within the hemorrhoidal node. Thrombosed external hemorrhoids do not have the potential to become cancerous. If thrombosed external hemorrhoids are not treated promptly, it may lead to increased pain or significant swelling of the thrombosed external hemorrhoids. In severe cases, it can cause the hemorrhoids to become trapped at the anal opening, unable to retract, or lead to necrosis due to cut-off local blood supply. Therefore, it is crucial to treat thrombosed external hemorrhoids as early as possible.
Is a mixed hemorrhoidal thrombosis external hemorrhoid serious?
When thrombotic external hemorrhoids are combined with mixed hemorrhoids, the situation is generally not severe. However, if it is in the acute phase, it needs to be dealt with as soon as possible. During the acute phase of thrombotic external hemorrhoids, there is severe pain in the local area of the anus, accompanied by swelling. The patient feels restless and the pain is unbearable, and thrombectomy surgery needs to be performed as soon as possible. If mixed hemorrhoids with thrombosis do not affect the patient's life, methods such as using anal plugs, hemorrhoid suppositories, or applying hemorrhoid cream to the anus can be used. Additionally, attention should be paid to not strain too much during bowel movements, as excessive straining can cause more severe congestion and swelling in the hemorrhoidal nucleus in the local area of the anus, thereby aggravating the condition of thrombotic external hemorrhoids.