I. Hemorrhoids
The traditional concept of hemorrhoids is a soft venous mass formed by the enlargement and varicosity of the submucosa of the human rectum and the subcutaneous venous plexus of the anal canal and anal verge. According to the performance and location, there are three types of hemorrhoids: internal, external and mixed.
1.Internal hemorrhoid: It is a pathological change and displacement of the supporting structure of the anal cushion, vascular plexus and arteriovenous anastomosis.
The main manifestations of internal hemorrhoids are blood in the stool and prolapse of the mass, which can be combined with thrombosis, impaction and difficulty in defecation. According to the severity of internal hemorrhoid symptoms, there are 4 stages.
Stage I internal hemorrhoids mainly present with blood in the stool or dripping blood, and the blood stops after the stool, without prolapse.
Stage II internal hemorrhoids mainly show that there is often blood in the stool and the nucleus of the hemorrhoid prolapses during defecation, which can retract by itself after defecation.
Stage III internal hemorrhoids mainly present with blood in the stool, and the nucleus of the hemorrhoid prolapses when defecating or standing for a long time, coughing, exertion or weight-bearing, which cannot retract by itself and needs to be retracted by hand.
The internal hemorrhoids have less blood in the stool, and the nucleus continues to prolapse and cannot be retracted, sometimes manifesting as impaction.
The external hemorrhoid is a distal subcutaneous vascular plexus expansion, blood flow stasis thrombosis or tissue hyperplasia.
Connective tissue external hemorrhoids: The main manifestation is a foreign body sensation in the anus or the anus is not easy to clean after the stool, and there may be anal dampness and itching when there is much secretion.
Varicose external hemorrhoids: The main manifestation is anal swelling and discomfort, which is obvious when defecating, and irregular swelling bulge with dark purple skin can be seen at the anal verge, which is soft to touch.
Thrombosed external hemorrhoid: It generally presents as a rounded mass protruding from the anal verge after straining to defecate, with severe pain, and a dark purple mass can be seen at the anal verge, which is hard and painful to touch.
Inflammatory external hemorrhoids: The main manifestation is burning pain, dampness and itching in the anus, which is obvious when defecating or moving.
3.Mixed hemorrhoids：The internal hemorrhoids and the corresponding external hemorrhoid vascular plexus are fused with each other to form a whole. The main performance of both internal hemorrhoids and external hemorrhoids symptoms, serious mixed hemorrhoids can be manifested as ring-shaped hemorrhoid nucleus prolapse.
Perianal abscess
Perianal abscess is an abscess formed by the infection of the anal glands spreading to the perianal rectum. The incidence rate accounts for 25% of anorectal diseases, mostly in young adults, more men than women.
The main manifestations of perianal abscess include anal pain and difficulty in defecation, often accompanied by systemic symptoms such as chills and fever. Localized redness and swelling can be seen, and there is a fluctuating feeling when pressed.
Once a perianal abscess becomes pus, it should be incised and drained in time to prevent further development and expansion of the abscess.
Anal fistula
Anorectal fistula is the sequelae of a perianal abscess that has broken down and is manifested as an interconnected tube in the rectum and outside the anus with sores at both ends, called a fistula, with the sore in the rectum being the internal port and the external port outside the anus. The incidence of anal fistula accounts for 1.67-3.6% of anorectal diseases and is common among young adults and infants.
About 95% of anal fistulas develop from perianal abscesses, which are effectively caused by infection of the anal fossa, and fistulas are formed when the perianal abscesses break down, which can be considered different stages of the same disease.
The classification of anal fistulas is simple and complex, and according to the location of the lesion, they can be divided into low and high anal fistulas.
It is important to note that once the fistula is formed, there is basically no possibility of self-healing, and the only way to cure it is through surgery, and to adhere to the correct method of changing medication after surgery to prevent pseudo-healing.
Four, anal fissure
Anal fissure is a chronic non-specific longitudinal infected ulcer on the skin of the anal canal, the wound is shuttle-shaped or oval, about 0.5-25px long, is a common disease, the incidence of anorectal diseases accounted for 20%, is second only to hemorrhoids. It is more frequent in young adults.
Early anal fissures have fresh wounds with neat fissure edges, shallow bottom, red and elastic, while chronic anal fissures have stiff, grayish margins due to repeated infection of the trauma, and are often accompanied by anal papillary hypertrophy, sentinel hemorrhoids and subcutaneous fistula formation.
The main manifestations of anal fissures are periodic anal pain, blood in the stool, and constipation. Anal fissure pain is cyclic, with pain during defecation, which may be relieved for a few minutes after defecation, followed by the production of severe pain that can last for several hours and is generally more common in the posterior part of the anal canal, followed by the anterior part. Anal fissure blood in the stool may appear as dripping blood, or blood on the stool, blood on hand paper, bright red color and small amount. Constipation is the fear of defecation due to pain, which causes feces to stay in the intestine for too long, water is absorbed and hard stools are formed, which in turn leads to the formation of anal fissures, forming a vicious circle.
The treatment principle of anal fissure is to stop pain and promote ulcer healing. Early anal fissure can be treated conservatively, such as keeping bowel movements open, local medication, anal dilation and injection. Chronic old anal fissures should be treated surgically.
V. Anal sinusitis (anal cryptitis).
It is an acute and chronic inflammatory disease in the anal flap, anal sinus and anal glands, often combined with anal papillitis and anal papillary fibroids, and is a very important potential foci of infection in anorectal diseases, about 85% of malignant anorectal lesions are related to anal sinus infection. The main manifestations are tightness of the anus, pressure pain at the inflammation of the anal saphenous fossa, and deepening of the anal saphenous fossa. Examination reveals congestion and edema with secretions.
Sixth, anal papillitis
Anal papillitis is a chronic inflammatory proliferative lesion with or without fibrosis, often accompanied by anal sinusitis, a common complication of anal fissure, anal fistula, etc., or can exist alone.
Seven, anal papillary fibroma detection anal papilloma
The anal papilloma is a common benign tumor of the anus, with a tendency to malignant transformation, and is recommended for early removal.
Eight, rectal polyps
Polyp is a generic term for all lesions that protrude and bulge into the cavity of the hollow organ.
Colorectal polyp is a general diagnostic term, which is a general term for elevated lesions of the large intestinal mucosa. According to the polyp morphology, they can be divided into broad-based, subtypical and tipped types. According to the number of polyps, a single polyp is a solitary polyp and is the most common. Multiple polyps are polyposis, and more than one hundred are polyposis.
Polyps have a tendency to become malignant. For polyps found, they should be removed immediately and the final treatment plan should be decided after the type is clarified according to histology.
Nine, colorectal cancer
Colon cancer, including colon cancer and rectal cancer, is one of the most common malignant tumors in China, and the incidence is on the rise. Among them, rectal and sigmoid colon cancers account for more than 60%.
Rectal cancer is a cancer that occurs between the dentate line and the junction of sigmoid colon and rectum, the onset of rectal cancer is relatively hidden, the early symptoms are not obvious and lack specificity, and the corresponding symptoms appear gradually as the tumor grows. In the middle stage, it may show abdominal pain, abdominal distension, thinning of stool and even difficulty in defecation.
Regarding the treatment principle of rectal cancer, surgical resection is still the main method, supplemented by radiotherapy, chemotherapy or immunotherapy, and Chinese medicine to improve the treatment effect.