Subscribe
162
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
Anal fistulas secondary to which disease?
An anal fistula generally originates from a perianal abscess, which is an infection focus formed near the anal sinuses in the local area of the anus. During its onset, there is obvious local redness, swelling, heat, and pain accompanied by the formation of a pus cavity containing pus. As the condition of the perianal abscess worsens, the local pus cavity will rupture and discharge pus, thus forming an anal fistula. After the rupture of a perianal abscess, its external opening cannot heal by itself, and there will be intermittent recurring discharge of pus. Therefore, it is necessary to carry out surgical treatment as soon as possible after the formation of an anal fistula, to prevent the enlargement of the local pus cavity or thickening of the fistula wall, which complicates later surgery and treatment and significantly impacts the patient's normal life.
What causes anal fissures?
Anal fissure is a series of clinical symptoms such as pain or rectal bleeding that occur due to the formation of a crack in the local sphincter muscle of the anus. The main reason for the occurrence of anal fissures is due to poor defecation habits in the early stages of the patient, or excessively dry stools, and excessive force during defecation, causing the local sphincter to burst, resulting in the fissure opening pain or bleeding. To treat anal fissures, it is first necessary to soften the patient's stools and adjust defecation habits. If the patient's diet is poor, it is recommended to maintain a light, easily digestible diet long-term. For those with dry stools, appropriate oral medications to lubricate the intestines and facilitate bowel movements can be used, or sesame oil can be applied around the anus before each defecation to lubricate the stool. If recurrent episodes of anal fissures occur, surgical treatment can also be directly performed. (Medication use should be under the guidance of a doctor.)
What should I do about anal bleeding and anal fissures?
If a fissure is visible to the naked eye at the anal sphincter during a digital rectal examination, it is primarily considered an anal fissure. Anal fissures generally cause severe local pain and bleeding from the fissure. The fissure is primarily due to the local crack being stretched or opened, causing bleeding from small blood vessels, and the blood from the fissure is usually bright red. To treat bleeding from an anal fissure, it is first necessary to soften the stool, as the occurrence of an anal fissure is mainly related to dry stools and difficulty defecating. Once the stool is lubricated, it can reduce the need to exert excessive force during defecation, lowering the possibility of stretching the local fissure. Topical application of hemorrhoid cream at the fissure, or combined with oral medications that cool the blood and stop bleeding, may be used. If there is repeated bleeding from an anal fissure, surgical treatment is also recommended. (Please use medications under the guidance of a professional physician, and do not self-medicate.)
How to deal with external hemorrhoids bleeding?
If external hemorrhoids bleed without apparent reason, it may be due to the rupture of thrombosed external hemorrhoids, leading to bleeding. Firstly, it is necessary to disinfect and clean the local wound to avoid accumulation of blood or contaminants and feces, which may cause infection of the wound. If the bleeding does not stop, topical hemostatic drugs or oral hemostatic drugs should be used for symptomatic treatment. If external hemorrhoids bleed and are accompanied by severe prolapse of internal hemorrhoids, it is recommended that the patient undergo surgical treatment to remove and ligate both external and internal hemorrhoids at the same time. This can further prevent exacerbation of bleeding and fundamentally treat hemorrhoids. Patients with bleeding external hemorrhoids must have a light diet and avoid irritating foods such as chili peppers and seafood. (The use of medications should be under the guidance of a doctor.)
Anal fissure bleeding symptoms
The most common clinical symptoms of anal fissure, apart from the intense tearing pain in the anal area, include bleeding during bowel movements. The bleeding from anal fissures is typically bright red, and the amount of blood can increase with the severity of the condition due to repeated stretching of the fissure. Particularly during acute episodes of anal fissures or after defecation, bleeding from the local fissure can be more significant. Patients with bleeding anal fissures generally have a history of dry stools, so the first step in treating anal fissure bleeding is to lubricate the stool. Additionally, topical medications should be applied to the bleeding fissure to promote healing, and hemorrhoid creams with hemostatic properties can be used locally to help stop the bleeding. (Please use medications under the guidance of a professional physician, and do not self-medicate.)
How long does it take to recover after surgery for an anal fistula?
Healing after surgery for an anal fistula requires some time, and the longer healing duration is mainly related to two factors: The first reason is that anal fistula is a localized infectious disease of the anus with the presence of a fistula. The principle of surgery is primarily to remove the fistula. Therefore, after the surgery, the wound surface from the removed fistula wall is relatively large and requires time to heal. The second reason is that the local area around the anus is a contaminated wound, with feces passing through daily. Feces are a significant source of contamination, so the wound healing is influenced by the irritation from feces, resulting in a non-sterile wound environment. Consequently, the wound healing rate after the surgery is slower compared to the healing rate of sterile wounds in other body tissues. Therefore, the recovery time after anal fistula surgery is approximately 3 to 4 weeks.
How to quickly eliminate the flesh masses of external hemorrhoids?
If a patient has an external hemorrhoid that has enlarged and they want to quickly or completely eliminate it, it is recommended to directly perform surgical removal. External hemorrhoids generally include thrombotic external hemorrhoids, varicose cluster external hemorrhoids, and inflammatory edematous external hemorrhoids. There are also some skin tag-like or connective tissue external hemorrhoids that do not exhibit clinical symptoms, and do not require excessive intervention in treatment. However, during an acute attack of thrombotic or inflammatory edematous external hemorrhoids, due to congestion or increased pressure in the local hemorrhoidal nucleus, severe pain can occur. You can choose to press with dilute salt water to promote the dissipation of edema. Complete removal requires surgical excision to avoid recurrent flare-ups of the condition.
Do hemorrhoids require surgery?
When severe hemorrhoids are in an acute attack phase, it is necessary to undergo surgical treatment as soon as possible. Besides surgery, treatment options for hemorrhoids also include conservative medication to alleviate symptoms. For mild hemorrhoids, or those that flare up less frequently, the primary treatment is conservative topical medication. However, when hemorrhoids repeatedly prolapse, cause pain, and result in significant rectal bleeding, affecting the normal functioning of the patient’s body, it is advised to promptly proceed with hemorrhoidectomy surgery. This helps avoid complications such as severe pain that interferes with normal living, or significant bleeding that could lead to anemia in patients, thereby worsening the condition and increasing the difficulty of future treatments. (Please use medication under the guidance of a professional physician, and do not self-medicate.)
Can you have children with rectal prolapse?
If a patient is diagnosed with rectal prolapse, they can still have children. However, childbirth can potentially worsen rectal prolapse, especially during natural delivery, where excessive straining in the pelvic and anal areas can exacerbate the condition. Therefore, if a patient already has rectal prolapse, it is advised to consider surgical removal treatment before pregnancy. If rectal prolapse occurs during pregnancy, external wash medications and hot compresses can be used to promote retraction. If rectal prolapse occurs during delivery, surgical treatment can also be carried out after childbirth. However, it is recommended that patients with severe rectal prolapse undergo cesarean delivery to avoid the excessive strain during natural childbirth, which could worsen the prolapse.
Can an anal fistula be left untreated for a lifetime?
If diagnosed with an anal fistula, one should not forego treatment indefinitely, as an anal fistula is a localized infectious disease of the anal region. Without active treatment, the infection may further spread, increase the number of fistula branches, and potentially induce a high, complex anal fistula. There is also a risk that the fistula and the infection might penetrate the local anal sphincter, reaching the ischioanal fossa and causing other infectious diseases. The primary treatment method for anal fistulas is surgical, mainly involving fistulotomy with seton placement, which thoroughly removes the local infection, allowing the anal fistula to heal. Neglecting active treatment could worsen the condition or increase the difficulty of future surgeries.