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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
Can you get pregnant with rectal prolapse?
Patients with rectal prolapse can become pregnant, but if diagnosed with rectal prolapse before pregnancy, it is advisable to first surgically remove the prolapsed mucosa. This is because during pregnancy, as the fetus grows, the pressure in the abdominal cavity gradually increases. Female patients may experience worsening of the rectal prolapse due to increased abdominal pressure, which could lead to increased congestion and edema, thereby exacerbating the severity of existing hemorrhoids or the severity of the rectal prolapse. Therefore, if there are symptoms of rectal prolapse before pregnancy, surgical treatment is recommended. If rectal prolapse occurs during pregnancy, conservative treatment with traditional Chinese medicine enemas can be chosen, and surgery can be considered after childbirth.
Causes of rectal prolapse
The causes of rectal prolapse primarily include older age or physical weakness leading to relaxation and sagging of the pelvic and rectal mucosa. Prolonged constipation can also lead to excessive straining during bowel movements, causing stress-induced sagging of the intestinal mucosa. Additionally, women who have gone through childbirth may experience rectal prolapse due to excessive straining of the pelvic floor muscles during delivery or increased abdominal pressure during pregnancy, which compresses the rectal mucosa. The treatment for rectal prolapse mainly consists of conservative medication or surgical removal. For mild cases of rectal prolapse, including those in children, traditional Chinese medicine enemas can be used. However, for moderate to severe cases, or cases where prolapse recurs frequently and significantly forms a complete prolapse, surgical removal is recommended.
How is rectal prolapse graded?
Rectal prolapse is generally graded into three degrees: first degree rectal prolapse, second degree rectal prolapse, and third degree rectal prolapse. First degree rectal prolapse is a relatively minor condition where the rectal mucosa protrudes but can retract back on its own. Second degree rectal prolapse is a moderate condition where the protruding mucosa extends approximately 5-10 centimeters, generally forming a conical shape, and requires the patient to manually reposition it. Third degree rectal prolapse indicates a severe condition, with the prolapsed mucosa typically extending beyond 10 centimeters. It may protrude with each incident and could also occur when the patient strains the abdomen or squats. The treatment of second and third degree rectal prolapse generally requires surgical intervention.
What should be noted for fecal incontinence?
Patients with fecal incontinence should first pay attention to the cleanliness and hygiene of the anal area. Due to fecal incontinence, there will be fecal residue around the anus, so it is important to clean up promptly when there is fecal residue. Since feces contain certain irritating substances, these can irritate the skin around the anus, causing pain, eczema, or even provoking bedsores. Therefore, patients with fecal incontinence must frequently change positions, clean regularly, and further carry out local treatment. The most common cause of fecal incontinence is relaxation of the anal sphincter. If it is confirmed that it is due to the aforementioned reason, an anal constriction surgery can be chosen to tighten the local sphincter, thereby preventing the feces from being expelled abnormally from the anus. It could also be due to the patient being elderly and frail, with a nervous system disorder, and the primary disease needs to be actively treated.
Differentiation between Colon Polyps and Colon Cancer
The most distinct diagnostic criteria between colon polyps and colon cancer are that colon polyps are benign lesions, whereas colon cancer is a malignant tumor of the intestines. Colon polyps are generally small in size or present as multiple polyps, with localized mucosal elevation. They may appear the size of mung beans or be pedunculated, and may be accompanied by mild abdominal pain, generally without blood in the stool. In contrast, during the onset of colon cancer, there is usually abdominal pain accompanied by bloody stools. In the later or advanced stages of colon cancer, after the tumor ruptures, it may also lead to severe gastrointestinal bleeding, as well as overall bodily wasting and anemia. The prognosis for colon polyps is relatively good; regular follow-up checks are sufficient. However, for colon cancer, if detected early, surgical removal can be an option. The survival rate in the middle and late stages is lower than in the early stage, and treatment may require a combination of radiotherapy and chemotherapy.
Can I exercise more if I have internal hemorrhoids bleeding?
If the patient is in a period of internal hemorrhoids bleeding, it is not advised for the patient to engage in excessive exercise and physical training, as the local mucosa is ruptured and bleeding during this period. Excessive exercise can potentially increase the pressure inside the local blood vessels, thereby increasing the amount of bleeding or worsening the condition. During internal hemorrhoids bleeding, related hemostatic treatments are necessary to prevent anemia from long-term repeated bleeding. Treatment mainly involves oral or topical hemostatic drugs. In terms of exercise and training, it is recommended to primarily walk gently and avoid vigorous exercises. If conservative medication does not effectively treat the bleeding, surgical ligation can also be considered for hemostasis. (Please use medications under the guidance of a doctor.)
Best treatment method for anal fistula abscess
The best treatment method for anal fistula and perianal abscess is surgical treatment, which is also the only curative method. Conservative treatment using drugs alone can only alleviate local inflammatory symptoms and cannot achieve complete cure. The main surgical method is the cutting and threading technique. This involves threading and ligating the infected area and the sphincter muscle. Through the slow cutting and drainage action of the ligature, the infection focus is removed while protecting the anal sphincter. Postoperatively, it is also important to pay attention to disinfecting and draining the local wound, ensuring proper dressing changes, and preventing poor drainage that could lead to infection or recurrence. It is advised that patients avoid spicy and irritating foods for the first six months after surgery.
How to deal with the internal opening of an anal fistula?
The internal opening of an anal fistula is generally located at the site of inflammation in the anal crypt. The primary reason for the formation of an anal fistula is the repeated outbreaks at the anal crypt, which lead to further infection and the formation of a perianal abscess. When the abscess cavity ruptures, it forms an external opening and the anal fistula. Surgical treatment is required for the internal opening of an anal fistula, generally involving a seton procedure that threads a line through the internal opening and part of the sphincter muscle, gradually cutting and draining the area slowly. If the inflammation at the internal opening is significant, it may also be necessary to excise part of the infected site in the anal crypt. Post-surgery care of the internal opening of an anal fistula primarily involves dressing changes, requiring daily thorough disinfection of the local area, ensuring clear drainage, to allow the granulation tissue at the internal opening to grow freshly, and to slowly heal the wound without infection. (Medication should be taken under the guidance of a doctor.)
What are the symptoms of rectal prolapse?
Rectal prolapse is a common clinical disease in proctology, primarily affecting children, postpartum women, and the elderly. Symptoms of rectal prolapse include varying degrees of bloating and a feeling of falling at the anus. Sometimes, due to the accumulation of mucosa at the anal opening, normal defecation is impeded, leading to constipation and difficulty in bowel movement. To examine and diagnose rectal prolapse, an anoscopy is necessary. Under anoscopy, the relaxed mucosa that accumulates can be seen at the mirror opening. Treatment for rectal prolapse in children may involve the use of traditional Chinese medicine retention enemas, which can gradually alleviate the prolapse as the body's condition improves. For postpartum women or the elderly, treatment may also involve traditional Chinese medicine retention enemas in combination with surgical excision. The primary surgical procedure used is a Hemorrhoidal mucosal circular stapling operation.
Can thrombotic external hemorrhoids exercise?
During the acute flare-up of thrombotic external hemorrhoids, there is congestion and edema of the local anal cushion, and thrombosis forms within the local hemorrhoidal nucleus and mucosa. It is not advisable for patients to engage in excessive exercise, as this may aggravate the congestion of the local hemorrhoidal nucleus and worsen the condition of thrombotic hemorrhoids. Excessive exercise and friction may also lead to rupture of the thrombus, resulting in pain or infection. During an acute episode of thrombotic external hemorrhoids, patients may choose to use hemorrhoid wash solution for hot compresses to alleviate local symptoms. If the symptoms are severe or the thrombus is large, surgical removal may also be an option. Patients with thrombotic external hemorrhoids need to pay attention to the duration of defecation, mainly keeping it under ten minutes, because prolonged defecation or excessive straining during bowel movements can increase vascular pressure in the local hemorrhoidal nucleus, leading to thrombus formation.